Part 2 book “Gateway to success in surgery” has contents: Cervical lymphadenopathy, parotid swelling, inguinal hernia, paraumbilical hernia, femoral hernia, incisional hernia, testicular tumor, basal cell carcinoma, squamous cell carcinoma, upper limb ischemia, and other contents. | Case 21 CASE 21 Cervical Lymphadenopathy Cervical Lymphadenopathy My patient Ranvir, a 30 year old male, resident of Haryana, presented with multiple swelling both side, of his neck for last 6 months. He noticed a single swelling in his left side of neck first graduate multiple swelling appeared both side of his neck. Swelling are gradually progressive, and painless. So he did not care about it initially but gradually he has got his history of weight loss, loss of appetite for last 3 months and Fever for last 2 months. The fever with swelling stay for 5-7 days and followed by a period of apyrexia. History of Abdominal pain and swelling in the lower limb (IVC obstruction) Features suggestive of TB like evening rise of temperature History of Exposure [to exclude sexually Transmitted Disease (STD)] History of Salivary gland swelling, conjunctivitis, dyspnea, cough, to no preauricular swelling (for Sarcoidosis)] GENERAL SURVEY: Patient is anaemic; pallor look, like white -coffee poorly/averagely nourished. On local Examination-There are multiple ovoid Swellings, more in the posterior triangle of neck, no swellings, moves with deglutition. No dental caries, oral hygiene Waldeyer’s ring appear normal. On palpation-The swellings are 2-4 cm in size nontender, discreate, rubbery in consistency, smooth surface mobile, free from overlying skin and underlying structure, Axillary, Inguinal lymph nodes not enlarged Systemic Examination • GIT- There is splenomegaly and hepatomegaly. Spleen is 14 cm on its axis • Liver is 4 cm enlarged on mid clavicular line. • No abdominal hymphadenopathy noticed. • Both testis appear normal, (to exclude testicular malignancy) • Others examination are essentially normal. So my provision diagnosis is - this is a case of Hodgkin's lymphoma but I like to put differential diagnoses for this case. It may be. 1. Tubercular Lymphadenopathy 2. Secondary syphilis 3. Chronic pyogenic lymphadenitis 4. Secondary metastatic lymph node. Why is you .
