AKT-5760

A 65-year-old man presents with a firm swelling at the base of his neck on the right hand side, just above the clavicle. He noticed it about two weeks ago. It is not painful. He is an ex-smoker who stopped smoking three years ago (before that he smoked 10 roll-up cigarettes per day for 35 years). On further questioning he has noticed a loss of appetite and weight loss of 8 lbs.

On examination he is apyrexial and has a firm non-mobile lymph node 3 cm in diameter in the right supraclavicular fossa. There are no abnormalities on examination of the respiratory system and there is no organomegaly on abdominal examination.

What is the most appropriate management strategy?