AAAAA
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24 year old male presented with multiple lymph nodes. Pt denied any IVDU, no hx of lymphoma. Pt is sexually active, his HIV test done recently was negative. SH: Pt is an university student in linguistics and is very sociable and is living with his girlfriend who is 48 year old.
She tested negative for HIV, Hepatitis B, C. Pt was very healthy until few months ago, c/o malaise, low-grade fever, slight weakness. Lab basically normal. CT scan of head negative. CXR no perihailar adenopathy. liver not enlarged. CBC nl electrolytes nl.
P.S. Pt died in less than 3 months
What is the diagnosis ?
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You can give a differential diagnosis. What are the differential diagnosis in a healthy 24 year old white male with HIV negative, CBC negative. CXR negative. blood smear negative for any signs of lymphoma.
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| AAAAA
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His alpha-fetal protein is not elevated, no testicular pain , no elevation of beta HCG
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| AAAAA
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SH: Pt is a devoted Roman Catholic church memebr, athletic and enjoy outdoor activities and is a Ph.D. student in my university. I saw him when his girlfriend brought him in the emergency room and he died within 3 months.
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| guayoman
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Troubling!!! makes you think about what life has in store for you and how little we know about medicine!
What is it AAAAA?
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| guayoman
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and how come my status changed from Senior member to Forum Junior!!!!!!!!!!!!!!!!!!!!!!!!!!????????
I am appalled!
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| AAAAA
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This young man of 24 year old is a friend of mine in the university pursuing a Ph.D. degree and originally from Europe to come to America for studies.
He pursued linguistics and spoke five or more different languages :English, Russian,
Hungarian, Romanian, German and French.
He developed multiple lymph nodes, shotty and became ill.
The biopsy showed melanoma.
He was started on aggressive chemotherapy but eventually succumbed to illness.
He is blond, very nice-looking young man, no homosexual activities but probably exposed to sunlight when he was much younger in Europe and eventually developed stage 4 melanoma and died.
Final diagnosis :Stage 4 melanoma at age 24 and died within 3 months
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| hitesh
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that's unfortunate. n a bit scary.
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| guayoman
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I'm so sorry.
Good thing that you are using this sad experience to let others learn from it.
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| AAAAA
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Actually the differential diagnosis is so short that we should know the answer.
There are 2.3 % rise of cancer mortality rate.
The only 4 major cancer that significantly rises in the past 10-20 years are
1. Lung cancer among women (137%) This is a male pt.
2. Prostate cancer among African-American (41%) This is not a Black pt.
3. Non-Hodgkin's lymphoma (when I saw him, I made the diagnosis of NH lymphoma but I was wrong
4. Melanoma (34%%) rise among mostly white pt.
There are black pt who got melanoma in their hands and feet but this sharp rise of melanoma among white male in early stage is very alarming.
This is actually an epidemiological question to test all of us about the significant rise of cancer among young white males.
The question points out he does not have testicular cancer (the right age group), also Hodgkin's and Non-Hodgkin's lymphoma can also be in this age group.
But the most alarming is the 137% rise among women with LUNG CANCER not breats cancer.
We spend too much time on breast cancer but forget women developed lung cancer in an very alarming rate and the rise is 137% compared with last 10 years
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| AAAAA
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Young white male exposed to excessive sunlight and developed sharp rise in melanoma after lung cancer among women, prostate cancer among Black and also Non-Hodgkin's Lymphoma !
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| achilles
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i feel sorry for your friend but thanks for sharing the experience aaaaa. when we talk and share experience like this there is someone we might be able to help in future. good post AAAAA. thanks.
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