Lymphoma

Painless lymphadenopathy, especially in the cervical or supraclavicular regions, is the most common presenting symptom of Hodgkin lymphoma. Davidson describes that patients may also experience systemic "B symptoms" such as fever, night sweats, and weight loss. Harrison adds that Hodgkin lymphoma often spreads in a predictable pattern from one lymph node group to another, and the presence of Reed-Sternberg cells on biopsy is diagnostic.

Stem Breakdown:

Fatigue, weight loss, and night sweats: These are "B symptoms," often seen in lymphomas.
Enlarged, non-tender lymph nodes in the cervical and axillary regions: Painless lymphadenopathy is a common presenting sign of lymphoma.
Option Analysis:

A) Hodgkin lymphoma: Hodgkin lymphoma typically presents with painless lymphadenopathy and "B symptoms," but it is more likely to involve mediastinal lymph nodes rather than widespread cervical and axillary nodes. The presence of Reed-Sternberg cells on biopsy confirms the diagnosis, but the stem lacks specific findings for Hodgkin lymphoma.
B) Non-Hodgkin lymphoma: This is the correct diagnosis. Davidson and Harrison explain that non-Hodgkin lymphoma (NHL) often presents with painless, generalized lymphadenopathy and systemic symptoms like weight loss and night sweats. NHL is more likely than Hodgkin lymphoma to cause widespread lymph node involvement.
C) Chronic lymphocytic leukemia (CLL): CLL causes painless lymphadenopathy and systemic symptoms, but it is also associated with an elevated white blood cell count (lymphocytosis), which is not mentioned in the case.
D) Tuberculosis: Tuberculosis can cause lymphadenopathy, particularly in the cervical region (scrofula), and systemic symptoms, but it typically presents with caseating granulomas on biopsy, and pulmonary involvement is common.

Hepatitis B and C testing. This should be done prior to therapy with rituximab in NHL