03-14-2008, 02:27 PM
A 64-year-old man has noted the presence of several lumps on the right side of his neck for the past 5 months. On physical examination he has firm, non-tender, movable lymph nodes palpable in right posterior cervical region. He does not have splenomegaly or hepatomegaly. Laboratory studies show Hgb 11.3 g/dL, Hct 40%, MCV 88 fL, platelet count 256,000/microliter, and WBC count 7230/microliter. A cervical lymph node biopsy is performed and on microscopic examination shows numerous crowded follicles of small, monomorphic lymphocytes. Which of the following is the most likely diagnosis?
A Chronic lymphocytic leukemia
B Poorly differentiated lymphocytic lymphoma
C Infectious mononucleosis
D Hodgkin disease, lymphocyte predominance type
E Reactive hyperplasia
A Chronic lymphocytic leukemia
B Poorly differentiated lymphocytic lymphoma
C Infectious mononucleosis
D Hodgkin disease, lymphocyte predominance type
E Reactive hyperplasia