Skill Checkup: A 62-Year-Old Man With Lumps on His Neck and Under His Arm

Ann S. LaCasce, MD, MMSc


May 25, 2023

The National Comprehensive Cancer Network (NCCN) guidelines recommend a whole-body PET/CT and/or chest/abdomen/pelvic CT with contrast of diagnostic quality as part of the initial diagnostic workup for MCL, while a CT of the neck with contrast may be helpful in selected cases.

The same NCCN guidelines do not recommend the use of colonoscopy or endoscopy as part of the initial diagnostic workup, as they do not affect management; however, endoscopic or colonoscopic evaluation of the gastrointestinal tract is necessary for confirmation of stages I-II disease and for assessing response to initial therapy.

PET/CT confirms two enlarged nodal groups, one at the cervical and one at the axillary lymph nodes. A bone marrow biopsy reveals no bone marrow infiltration. The patient has stage II bulky disease.


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