Head and neck tumours: biopsy for suspected lymphoma: practice question

A ENT question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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ENT · Head and neck tumours: biopsy for suspected lymphoma

Sample item

A 28-year-old has a painless, rubbery 4 cm cervical lymph node with night sweats and weight loss. Fine needle aspiration is inconclusive. What is the next best step?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Excision biopsy of the node for histology and architecture

Diagnosis and subtyping of lymphoma needs the nodal architecture and immunohistochemistry, so an excisional biopsy of an intact node is preferred over FNAC. Core biopsy is an alternative when excision is not possible. Delay worsens outcome.

Option by option

  • A. Incisional drainage

    Drainage is not indicated for a solid node.

  • B. Empirical antituberculous therapy

    Empirical therapy without tissue is inappropriate.

  • C. Excision biopsy of the node for histology and architecture (correct)

    Correct. Architecture is essential for lymphoma diagnosis.

  • D. Repeat FNAC and observe for a year

    Prolonged observation delays the diagnosis.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this ENT question

What is the answer to this ENT question?

The best answer is C, Excision biopsy of the node for histology and architecture. Diagnosis and subtyping of lymphoma needs the nodal architecture and immunohistochemistry, so an excisional biopsy of an intact node is preferred over FNAC.

Why is "Incisional drainage" not the answer?

Drainage is not indicated for a solid node.

Why is "Empirical antituberculous therapy" not the answer?

Empirical therapy without tissue is inappropriate.

Why is "Repeat FNAC and observe for a year" not the answer?

Prolonged observation delays the diagnosis.

What concept does this question test?

It tests Head and neck tumours: biopsy for suspected lymphoma in ENT. Core biopsy is an alternative when excision is not possible. Delay worsens outcome.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Head and neck tumours: biopsy for suspected lymphoma?

Learn tuning fork results and audiogram patterns by sketching them. Then use the flashcards and the other ENT questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.