19th July 2023

A 63-year-old man is referred to gastroenterology outpatients by his GP with a 3-month history of generalised abdominal pain

A 63-year-old man is referred to gastroenterology outpatients by his GP with a 3-month history of generalised abdominal pain and unintentional weight loss of approximately 10kg. He complains of feeling sweaty and intermittently hot, especially at night. His history includes hyperlipidaemia, hypertension, coeliac disease (diagnosed aged 12; well controlled on a strict gluten free diet), atrial fibrillation (on apixaban) and right knee osteoarthritis. On examination, he has enlarged cervical lymph nodes and a palpable mass in the right iliac fossa. He is booked in for an urgent upper GI endoscopy and colonoscopy.

Based on his clinical history and presentation, what is the most likely diagnosis?

Select the SINGLE most appropriate option from the list below. Select ONE option only.