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Post-streptococcal Glomerulonephritis — MRCGP AKT MCQ

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HardRenalPost-streptococcal GlomerulonephritisMRCGP AKTUKMLAPARAMRCP Part 1

A patient has progressive, painless cervical lymphadenopathy suspicious for non-Hodgkin lymphoma. A needle core biopsy was non-diagnostic, and surgical assessment finds excision feasible with low procedural risk. Which diagnostic step should follow?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: C — Arrange excision biopsy rather than repeating the needle core biopsy

The best answer is “Arrange excision biopsy rather than repeating the needle core biopsy”. NICE advises excision biopsy first when feasible because architecture and sufficient material are important for lymphoma classification. If an initial core is non-diagnostic, excision is preferred to a second core when surgery is feasible. Cytology, empirical steroid response and marrow sampling do not replace diagnostic nodal tissue in this setting.

Reference: NICE NG52, Non-Hodgkin lymphoma: diagnosis and management: https://www.nice.org.uk/guidance/ng52/chapter/Recommendations