1. Case 350: A 20-year-old man with an enlarged cervical lymph nodes

2. H & P
enlarged lymph node in his posterior neck. It is 3x3cm, firm, nontender, freely moveable nodule
no fever, no icterus and the thyroid gland is normal, the trachea is not deviated and there are no signs of hypothyroidism
No other noticeable lymphadenopathy , no organomegaly
no physical complaints other than feeling weak and tired

3. Reactive hyperplasia

4. Gross photo of the excised node

5. Low power of lymph node-- note effacement of architecture

6. mid power--

7. High power

9. Labs Hemoglobin: 12.5g/dL, Hct: 38%, RBC'S: 4.5 x106uL MCV: 84 um3
WBC count: 6.2x 103/uL
Differential: Normal
Platelet count: 186x103/uL
Peripheral smear: normal

10. TSH: 3 µU/m
AST: 31 IU/L
BUN: 18 mg/dL
ALT: 28 IU/L
Creatinine: 1.1 mg/dL
Alkaline Phosphatse: 64 IU/L
Serum Calcium: 9 mg/dL
Urinalysis: Sp. Gravity: , Negative-Sugar, Bile, Protein, Blood Micro-sediment: Occasional WBC's, no casts.
Immunology:
VDRL: Non-reactive
ANA: Negative
Monospot: Negative
EB virus ab Positive

11. Low power view of Nodular Sclerosis HD-- note the broad band of
fibrosis