Hey folks, just a quick reminder that this episode is now meant to be used for medical advice, just good old-fashioned education.

All patient information has been modified to protect their identity, and the views expressed in our podcast do not necessarily reflect the opinion of our employers.

Welcome back to clinical problem solvers. I am Melika Gill. I'm a fourth year medical student at Virginia

Commonwealth University and I'm pursuing internal medicine. I'm very excited for today's episode. I'm here

today with Kelly. I'm Kelly. I'm a second year internal medicine resident and I'm here with Aaron.

Hey everyone. I'm Aaron Sable. I'm currently a third year internal medicine resident in Mercy Health,

Muskegon. Lindsay, what do we have in store for today? Hello, hello. Y'all, you're in for a treat tonight. Kelly and Aaron are incredible, and I had the pleasure of being able to practice with them the other night, and you're in for a treat. Tonight, we are featuring a human diagnosis case. We encourage you to download the app and solve the daily morning report cases.

It's a great way to get a rep in in a short amount of time. Kelly and Aaron and I are blinded to

tonight's case. We will try to solve the case in real time. We encourage you to pause and reflect after each

aliquotum information and before you listen to our responses. The case creator is Malika Gill and Dr. Patrick

Fadden and the editor for the case is Malika. Take it away. A 34-year-old healthy male presents to the

emergency room with complaints of shortness of breath and right-sided pleuritic chest pain for one week.

He also notes weight loss, fevers, chills, and dredging

night sweats over the last two weeks. He was initially seen five months ago for what he describes

as a knot in his left groin. He had a CT showing a hypodense mass in the subcutaneous fat

measuring 4 by 4 by 5.6 centimeters. Surgery recommended admission, but the patient opted

for outpatient follow-up, which was never completed. The patient was seen again the following

month in the emergency room for similar symptoms. At that time, an ultrasound of the left groin

region was done, which showed multiple enlarged hyperremic lymph nodes and a few necrotic lymph nodes measuring from 0.9 to 3.8 centimeters.

He was referred to oncology and interventional radiology for further workup, but these appointments were never completed.

He has a past medical history of osteoarthritis. He has no surgical history.

Family history is significant for a mother with tight-to two diabetes and hypertension and a maternal aunt with liver cancer.

...