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NBME Form 7 Practice Test

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A firm rubbery supraclavicular lymph node is most suggestive of which diagnosis?
Correct Answer:
Lymphoma
Explanation:
When a clinician feels a lymph node, consistency matters as much as size. A firm but rubbery, mobile node in the supraclavicular area fits the pattern often seen with lymphoma, where lymphoid tissue expands in a way that makes the node feel firm and pliable rather than hard and fixed. Reactive nodes tend to be soft and tender; TB lymphadenitis usually produces firm, matted nodes that may become fluctuant or show caseation; metastatic cancer nodes are typically hard, craggy, and fixed to surrounding structures. The supraclavicular location further raises concern for malignancy, and the described rubbery firmness is most classically associated with lymphoma.

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