A 32-Year-Old Woman Is Evaluated Because of a Painless Swelling

A 32-year-old woman is evaluated because of a painless swelling in her lower neck. She noted the swelling about 3 weeks ago and now thinks it is getting larger. She has no history of foreign travel. She smokes but does not drink alcohol. She owns a cat. She has not had fever or unexplained weight loss, but has had night sweats twice in the past week. She has been feeling fatigued lately and has noted dyspnea on exertion. On physical examination, a 3 X 5-cm left supraclavicular lymph node is palpable. It is firm but not rock-hard and is nontender. The remainder of her physical examination and results of a complete blood count are normal. What is the best next step in this patient"s management?

A) Observe for 2 weeks
B) Refer her to an otolaryngologist for a thorough search for a primary lesion of the oropharyngeal mucosa
C) Administer oral antibiotics and observe the course of the node
D) Perform a needle aspiration of the node
E) Perform a chest radiograph