History: The patient was a 38 year-old African American woman who presented with a painless neck nodule. The nodule was non-tender and the patient could not clearly recall when did she recognized the nodule but it had been there for some time as per the patient. No constitutional symptoms were reported by the patient. The patient has no history of occupational exposure to beryllium or other chemicals. A CT scan was performed which demonstrated multiple enlarged lymph nodes in the mediastinum. The differential diagnoses include lymphoma, metastatic carcinoma, mycobacterial and fungal infection, sarcoidosis and other non-infectious granulomatous disease. The nodule in the neck was excised. The specimen was that of a lymph node, 1.8 cm in greatest dimension, with a solid cut surface. A touch preparation was performed and there was no evidence of lymphoma or metastatic carcinoma. The specimen was submitted for histologic examination. The angiotensin-converting enzyme (ACE) level of this patient was elevated.
What is your diagnosis? Discussion
