Woman 56 yo slowgraded fever for one month, swelling of the neck and left supra clavicular area.
Ultrasound the neckpresented normal thyroid and many lymph nodes hypoechoic without hilus nodes (US image )
Abdomen ultrasound scan detected aorta elevated by hypoechoic mass, para-retro aortic just prolonged to pelvis (US 1, US 2) and sonologist suggested lymphoma.
MSCT with CE for staging the mass nodes supreclavicular left , mediastinal, para aortic and inguinal area..( CT 1, CT2, CT3) = stage IV LYMPHOMA
BLOOD TESTS with high beta microglobuline and ferritin.
Biopsy supraclavicular node and histo immuno chemistry report were LYMPHOMA diffuse large B CELL.