This study aims to present the assimilation process of a case of Follicular Lymphoma and its diagnosis through structured clinical reasoning using a gamified platform called MEDTest, which features an easy-to-access and user-friendly decision tree software as a service.

The MEDTest gaming platform, developed by academics and educators, with the capability to explore various medical areas, including Hematology and its subspecialties, served as the primary tool. The intention is to demonstrate how a decision tree, assimilating real clinical cases from the medical environment, can be constructed through the practice of clinical reasoning, developed through a game in a virtual environment.

Reference Case: G.S, a 57-year-old Caucasian male, presented with a complaint of weight loss of 15 kg in 3 months, lymphadenopathy, fatigue, and loss of appetite, with no significant changes in the physical examination. The utilization of MEDTest enabled the creation of a decision tree for the user team, simulating the medical team's approach to defining the patient's conduct and investigative plan. Based on the clinical presentation, laboratory tests, tomography, and inguinal lymph node biopsy were performed, resulting in the diagnosis of Grade I Follicular Lymphoma, a disease belonging to the complex group of Non-Hodgkin Lymphoma.

Users demonstrated acceptable performance during platform usage. Additionally, it was observed that the decision tree adequately addressed the complexity of the proposed clinical case, showing potential for use in studies, research, and activities for medical educators and students. MEDTest can assist in studying the recognition of various diseases, including neoplasms like Grade I Follicular Lymphoma (FL), as rapid and accurate diagnosis directly impacts patient prognosis. FL is characterized by being indolent, with a tendency to recur and progress over the years. Moreover, Follicular Lymphoma constitutes about 25% of all NHL cases in Western countries, especially in individuals aged 50 to 60 years. Patients with FL may be symptomatic or asymptomatic, and upon detection of suspicious nodules, an excisional lymph node biopsy is requested, providing a confirmatory diagnosis of the patient's health condition. Therapeutic approaches vary according to FL staging. For Grade I FL, watchful waiting is initially recommended, without any antineoplastic chemotherapy unless symptoms, tumor mass increase, or extranodal involvement occur. After the appearance of clinical manifestations, patients may benefit from radiotherapy and RCHOP chemotherapy.

The importance of early analysis and treatment is emphasized to promote better prognosis and decrease complications throughout the disease course, such as infertility and secondary neoplasms. It is important to note that MEDTest is not intended as a consultation tool but rather aims to enhance the capacity of professionals to develop accurate clinical thinking from an academic standpoint. An additional benefit is that the decision tree has the ability to simulate complications, adding complexity to the cases.