A 52-Year-Old Man Comes to the Office Due to a Progressively

question 310

Multiple Choice

A 52-year-old man comes to the office due to a progressively enlarging neck mass, fatigue, and weight loss over the past 2 months.  Physical examination shows enlarged, firm, and nontender cervical lymph nodes.  The patient also has enlarged tonsils, bilateral axillary lymphadenopathy, and splenomegaly.  Excisional lymph node biopsy reveals diffuse sheets of atypical, large B cells that have replaced the normal tissue architecture.  In situ hybridization of the tissue specimen is positive for Epstein-Barr virus.  Which of the following risk factors is most strongly associated with development of this patient's condition?

• A)Advanced HIV infection
• B)Aspirin and nonsteroidal anti-inflammatory drug use
• C)Cigarette smoking
• D)Radiation exposure
• E)Socioeconomic status

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