The patient came in with a complaint of a growing mass on the neck.

Four weeks prior to admission, the patient suddenly noticed a mass that is said to be solid, firm, non-movable, non-tender, warm to touch with redness over the area. It is said to be about the size of an old one-peso coin and located at the right anterior portion of the neck. It is associated with cough and colds. There were no aggravating or relieving factors identified. He went to the health centre for a consult and was prescribed an unrecalled drug which he took once a day with compliance.

Three weeks prior to admission, the mass continued to increase in size and was said to be the size of a calamansi. It is associated with weight loss of about 6 kilograms, difficulty in swallowing solid food, hoarseness of voice and difficulty in breathing when flat in bed. He can only tolerate food processed with a blender or oatmeal. No consult or therapy done.

The said mass continued to grow also affecting the left anterior portion of the neck and he also experienced difficulty in swallowing liquids which prompted consult at the UERM Hospital.

He does not smoke but occasionally drinks alcoholic beverages. His meals usually include rice, fish and vegetables. There is no family history of thyroid problems or cancer. He reports easy fatigability and excessive sweating. He denies experiencing pain on the affected area, hyperactivity, irritability, insomnia, palpitations, heat or cold intolerance, diarrhea, and constipation.

For this case, my clinical impression is TB lymphadenopathy versus Lymphoma.

Need to read on Harrison. 

P.S. Doing this stupid paper in Zen Tea Banawe. I hope I finish asap. I hate bringing work at home.