Lymphadenopathy (TB/Lymphoma/Metastatic) MCQ Quiz | Head & Neck

1. A 25-year-old patient presents with multiple, matted, non-tender lymph nodes in the posterior triangle of the neck, with one of them showing signs of skin discoloration and sinus tract formation. What is the most likely diagnosis?

2. The presence of “B symptoms” (unexplained fever, drenching night sweats, and significant weight loss) is most classically associated with which cause of lymphadenopathy?

3. A palpable, hard, left supraclavicular lymph node (Virchow’s node) is most concerning for metastasis from which primary site?

4. On Fine Needle Aspiration Cytology (FNAC) of a cervical lymph node, the pathologist reports “caseating granulomas with epithelioid cells and Langhans giant cells.” This finding is highly suggestive of:

5. The presence of Reed-Sternberg cells on an excisional lymph node biopsy is pathognomonic for:

6. A 60-year-old chronic smoker presents with a solitary, “stony-hard,” fixed, and non-tender lymph node in the neck. Which of the following is the most probable diagnosis?

7. Which diagnostic test for tuberculosis offers rapid results and detects rifampicin resistance simultaneously?

8. The term “rubbery” is classically used to describe the consistency of lymph nodes in which condition?

9. Level II neck nodes (upper jugular) are the primary site of drainage for which of the following areas?

10. A “cold abscess” (an abscess without the classic signs of inflammation) is a characteristic feature of:

11. Ann Arbor staging is a system used for:

12. Metastasis to a submental (Level IA) lymph node is most likely from a primary carcinoma of the:

13. The standard treatment for tuberculous lymphadenitis (scrofula) involves:

14. Which is the most definitive investigation for diagnosing lymphoma?

15. A patient with painless, progressively enlarging cervical nodes, splenomegaly, and a normal complete blood count is suspected to have lymphoma. What is the most likely consistency of these nodes on palpation?

16. Waldeyer’s ring, which includes the tonsils and adenoids, is a common extra-nodal site for which type of malignancy?

17. A key differentiating feature between tuberculous nodes and metastatic nodes on clinical examination is that tuberculous nodes are often:

18. A 65-year-old man with a history of heavy alcohol and tobacco use is found to have a hard, fixed Level III lymph node. What is the most important next step in management?

19. Which virus is strongly associated with nasopharyngeal carcinoma, a common cause of metastatic cervical lymphadenopathy, especially in patients of Southern Chinese descent?

20. What is the significance of a “shotty” lymph node on palpation?

21. The “collar stud” abscess, where pus tracks from deep cervical fascia to the superficial fascia, is classically associated with:

22. In a patient with suspected metastatic squamous cell carcinoma in a neck node of an unknown primary, where is the most statistically likely location of the primary tumor?

23. Which of the following statements about head and neck lymphoma is most accurate?

24. What is the most common cause of cervical lymphadenopathy overall in children and young adults?

25. A “red flag” sign for malignancy in a patient with neck lymphadenopathy is: