28-year-old Chinese architect presents with painless lumps in the neck. This
has been present for the last 7 weeks. He also says he has lost about 8 kgs in
weight over the last six months and he has had fever with night sweats. He
smokes 20 cigarettes a day and consumes 24 units of alcohol a week. No
relevant past illnesses or family history.
On examination there are several enlarged lymph nodes in
the right supraclavicular fossa.
No other abnormal clinical findings.
Investigations are as follows:
Hb 10.9 g/dL
MCV 80 fl
WBC 15.0 x 109/L
Lymphocytes 35 %
ESR 54 mm in 1st hour
In this patient which of the following tests would you
arrange in order to make a diagnosis?
Lymph node biopsy
Serum angiotensin converting enzyme levels