Case history
Case history
A 25-year-old man presents to his general practitioner with a slowly enlarging, painless right neck mass. He denies recent upper respiratory tract infections, fevers, night sweats, or unintentional weight loss. He is otherwise healthy. Social history and family history are unremarkable. On examination he is afebrile with normal vital signs. Pertinent findings include a 3-cm, firm, round, non-tender, mobile mass in the mid-right neck. There is no other peripheral lymphadenopathy. Liver and spleen are not enlarged.
Other presentations
The most common presentation of HL is painless cervical and/or supraclavicular lymphadenopathy. Axillary and inguinal lymphadenopathy is less common. The mediastinum is frequently involved and occasionally symptoms include shortness of breath and/or cough. Up to 30% of patients present with B symptoms, defined as unexplained, recurrent fevers of 38°C (100.4°F) or higher, drenching night sweats requiring change of bed clothes, and/or >10% weight loss in the last 6 months.[4][5] B symptoms are more common in patients with advanced disease. Other systemic symptoms not categorised as B symptoms include generalised pruritus and alcohol-induced pain at the site of a tumour mass.
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