instruction: hi doctor I am a 32 year old male my height is feet and weight is 145 labs I am facing a significant unexplained weight loss of more than 45 labs in four months my normal weight since high school is 185 to 180 labs I am having episodes of significant and frequent drenching night sweats also I have chronic persistent fatigue and occasional non specific itching I have a family history of lymphoma with my paternal uncle and maternal cousin my ultrasound of lymph nodes has two different impressions the first one was clear bilateral lad suspicion of neoplastic etiology seen at level and the second opinion was clearly reactive bilateral nodes seen at level and in your opinion what would be the appropriate course of action either fob or excisional biopsy due to the symptoms and history also if you can interpret films then I would appreciate your additional opinion from a differential diagnosis standpoint what is at the top
output: hi based on your query and attached images my opinion is as follows fnb for further information consult a hematologist online