02/06/2024
A 9-year-old boy who had recently emigrated from Brazil presented to the emergency department with a 3-week history of neck swelling, fevers, and weight loss. On physical examination, there was fixed, tender lymphadenopathy in the posterior auricular, submandibular, and occipital chains. Laboratory testing was notable for peripheral eosinophilia. Tests for cryptococcus, histoplasmosis, and human immunodeficiency virus were negative. CT scan of the neck showed hyperattenuating cervical lymphadenopathy on both sides. Lymph node biopsy results are shown. What is the most likely diagnosis? https://nej.md/IC01182024