Question

Your patient is a 65-year-old man with progressive fatigue. His fatigue started -7 months ago, and it is worsening; sometimes, he feels ""too tired even to get out of bed"". Over the last month, he has started having bone pain, and he has stopped his usual evening walks because of a decreased exercise tolerance. He has also noticed that he is sweating at night. At the same time, he has started having a feeling of abdominal fullness and early satiety; it is accompanied by a constant sensation of bloating, even after a small sandwich or an apple. He has lost approximately 5 kg over the last 6 months. Physical examination reveals liver palpable about 4 cm below the right costal margin, and the spleen is palpable about 8 cm below the left costal margin; the rest of his physical examination is within normal limits. His laboratory analyses are below:

What will be your therapeutic approach?
A. Watchful waiting
B. Immunomodulatory agents (Thalidomide)
C. Splenectomy
D. Androgen (Danazol)
E. Splenic radiation
F. Anti-gout agent (colchicine)
G. Tyrosine kinase inhibitor (Ruxolitinib)

Answer 1

The patient's symptoms and physical examination findings suggest a possible diagnosis of lymphoma. The therapeutic approach for lymphoma typically involves chemotherapy, radiation therapy, and targeted therapies like immunomodulatory agents and tyrosine kinase inhibitors.

Step-by-step explanation:

The patient's symptoms, including progressive fatigue, bone pain, night sweats, and weight loss, along with physical examination findings of an enlarged liver and spleen, suggest a possible diagnosis of lymphoma. Lymphoma is a type of cancer that affects the lymphatic system, which includes the lymph nodes, spleen, bone marrow, and other organs involved in immune function. The therapeutic approach for lymphoma typically involves chemotherapy and/or radiation therapy, depending on the specific type and stage of the disease. Immunomodulatory agents, like Thalidomide, and tyrosine kinase inhibitors, like Ruxolitinib, may also be used to target specific cancer cells and reduce symptoms.