A patient with night sweats, weight loss, shortness of breath, and axillary nodules denies sputum. Which diagnosis is most likely?

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Night sweats and weight loss are B symptoms that point to a systemic process, often a malignancy like lymphoma. The presence of axillary nodules signals lymphadenopathy, which is a hallmark finding in lymphoma—nodes can enlarge in the armpit region and may be painless. Notably, the patient denies sputum, which makes a primary pulmonary infection such as pneumonia less likely. Tuberculosis can also cause night sweats and weight loss, but it typically presents with a cough and sputum, and the nodal pattern here fits lymphoma more closely. Shortness of breath can occur with lymph node enlargement affecting the chest or with anemia from marrow involvement, both seen in lymphoma. So the combination of systemic B symptoms with focal axillary lymphadenopathy most strongly supports lymphoma.