Case presentation A 57-year-old man working in an industrial manufacturing company visited a hospital with the chief complaint of coughing for one month, along with dyspnea and fatigue during exercise. Medical history The patient did not have a history of illness. Social history He was a cigarette smoker for 40 years. Physical examination Bilateral enlargement of cervical lymph nodes Pulse rate - 102 beats/min Blood pressure - 110/70 mmHg Respiration rate - 20 breaths/min Lost 5 kg in 2 years, presently weighs 50 kg Blood test Hemoglobin in complete blood cell count: 12.6 g/dl Erythrocyte sedimentation rate: 73 mm/h Radiologic findings A thyroid and cervical ultrasound was performed.
The thyroid was normal. Level IV and level VI cervical lymph nodes and supraclavicular lymph nodes on both sides were enlarged. High-resolution computed tomography (HRCT) of the chest was performed (Cover…
