A 43-Year-Old Man Comes to the Office Due to Malaise

A 43-year-old man comes to the office due to malaise, night sweats, and cough for the past several weeks.  He has also lost 4.5 kg (10 lb) over the past 4 months.  The patient has no appreciable medical history and has not traveled recently.  He has spent the last 10 years working as a respiratory therapist at an urban hospital.  Chest x-ray is shown below. A palpable lymph node in the supraclavicular bed is biopsied and pathology reveals well-formed, noncaseating granulomas.  Which of the following is the most likely diagnosis?

A) HIV infection
B) Hodgkin lymphoma
C) Metastatic adenocarcinoma of the lung
D) Metastatic squamous cell carcinoma of the lung
E) Mycobacterium avium complex
F) Mycobacterium tuberculosis
G) Sarcoidosis

Correct Answer:

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