Hematologic Neoplasms

The 46-year-old male patient has been showing various signs of inflammation for 6–8 weeks: Sore throat, canker sores, joint pain and febrile rhinitis. There is an unintended weight loss of 2–3 kg. Physical examination reveals findings that are inconspicuous for the patient’s age. How do you proceed now?

A 56-year-old man presents with concentration problems, dorsal pain, fatigue and a marked increase in urination. His family history is positive for bronchial carcinoma. Physical examination reveals tenderness upon percussion in the lumbar spine. How do you proceed?

A 58-year-old male patient complains of painless swelling of the cervical lymph nodes, night sweats with change of clothes, inappetence and bloating. The spleen is palpable beneath the costal arch. What further diagnostic steps do you now take?

An 80-year-old male patient suffers from exertional dyspnoea and progressive fatigue. There is no fever, night sweats, weight loss, haematoma nor marked tendency to infection. The blood count control shows a newly manifested pancytopenia. What is your suspicion, and how do you proceed?

A 59-year-old male patient with a long history of smoking presents with dextral cervical lymph node swelling, unwanted weight loss and increased nocturnal sweating. The physical examination yields unremarkable results except for lymphadenopathy and an elevated temperature (38.4 °C / 101.1 °F). How do you proceed?

In a 75-year-old male patient with arterial hypertension and type 2 diabetes mellitus, serum electrophoresis shows an M gradient of 10 g/l. The standard blood count is unremarkable except for the creatinine value (2 mg/dl). What are your next steps?

A 47-year-old female patient in s/p adjuvant chemo- and radiotherapy in condition of known breast carcinoma, currently in complete remission, shows tricytopenia with leading progressive leukopenia during outpatient follow-up. The patient reports intermittently subfebrile temperatures. How do you proceed?

A 27-year-old male patient presents with progressive cervical swelling sinistrally, fatigue and weight loss. The clinical examination shows a clear swelling of the lymph nodes (approx. 3 c× 3.5 cm) on the left cervical side. The routine laboratory examination shows an elevated ESR. What are your next steps?

A 32-year-old, well-trained patient is hospitalised with progressive complaints in the left upper abdomen while walking, which have been present for one month. For the past week he has had visual disturbances when reading. How do you proceed?

A 72-year-old male patient presents for his annual check-up. He is in excellent health and active in sports. Routine laboratory examination shows leukocytosis with a conspicuously high proportion of lymphocytes and discrete thrombocytopenia. What is your tentative diagnosis?

A 57-year-old female patient presents with increasing pain and tightness in the left calf, symptoms of an upper respiratory tract infection with mild dyspnoea, and fatigue. A month ago, she had reportedly undergone surgery on the left meniscus without any complications.