Skill Checkup: A 55-Year-Old Man With Fatigue, Fever, Night Sweats, and Swollen Lymph Nodes

Karl J. D'Silva, MD


June 13, 2022

The Skill Checkup series provides a quick, case-style interactive quiz, highlighting key guideline- and evidence-based information to inform clinical practice.

A 55-year-old man from Vancouver, British Columbia, Canada, presents with fatigue, fever, and night sweats for the past 3 months. His height is 6 ft, and weight is 200 lb (body mass index of 27.1). He reports having had infections every month for the past 3 months, and upon physical examination, he has swollen lymph nodes. He does not have any significant comorbidities; he is HIV negative and tests negative for COVID-19. Blood testing reveals white blood cell count of 9 × 109/L, lymphocyte count of 5300 × 109/L, hemoglobin level of 10 g/dL, and a platelet count of 98 × 109/L. Bone marrow aspiration revealed 32% monoclonal lymphocytes. Immunophenotyping demonstrated the presence of CD3, CD10, CD20, CD23, and cyclin D1.


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