Differential Diagnosis for 32 y/o Male with Cervical Lymphadenopathy, Bilateral Inguinal Lymphadenopathy, Recent Significant Weight Loss, and Night Sweats

Single Most Likely Diagnosis

• Hodgkin Lymphoma: This diagnosis is considered the most likely due to the combination of cervical and inguinal lymphadenopathy, significant weight loss, and night sweats, which are classic symptoms of lymphoma, particularly Hodgkin lymphoma.

Other Likely Diagnoses

• Non-Hodgkin Lymphoma: Similar to Hodgkin lymphoma, non-Hodgkin lymphoma can present with lymphadenopathy, weight loss, and night sweats, making it a likely consideration.
• Tuberculosis: Although less common in some regions, tuberculosis can cause lymphadenopathy, weight loss, and night sweats, especially in individuals with exposure history or from endemic areas.
• HIV Infection: HIV can lead to persistent generalized lymphadenopathy, weight loss, and night sweats, particularly in the absence of antiretroviral therapy.

Do Not Miss Diagnoses

• Lymphoma (specifically, Burkitt Lymphoma or other aggressive types): While already considered under likely diagnoses, it's crucial not to miss any form of lymphoma due to its potential for rapid progression and the need for immediate treatment.
• Sarcoidosis: Although less likely to cause significant weight loss and night sweats, sarcoidosis can cause lymphadenopathy and should be considered, especially if other symptoms like skin lesions or eye involvement are present.
• Infectious Mononucleosis (EBV): Typically seen in younger individuals, but can occur at any age, and may present with lymphadenopathy and systemic symptoms.

Rare Diagnoses

• Castleman Disease: A rare disorder that can cause lymphadenopathy, weight loss, and night sweats, often associated with HIV infection or other immunodeficiencies.
• Kikuchi-Fujimoto Disease: A rare, self-limiting condition that causes lymphadenopathy, often accompanied by fever and night sweats, more commonly seen in young women but can occur in men.
• Rosai-Dorfman Disease: A rare histiocytic disorder that can present with lymphadenopathy and systemic symptoms, including weight loss and night sweats.

Each of these diagnoses requires a thorough workup, including imaging studies (e.g., CT scans), laboratory tests (e.g., complete blood counts, blood chemistry, and specific markers like lactate dehydrogenase for lymphoma), and potentially a lymph node biopsy for definitive diagnosis.