A 38-year-old woman presents with painless cervical lymphadenopathy, night sweats, and 8 kg weight loss over 3 months. CT shows mediastinal and cervical lymphadenopathy. Lymph node biopsy shows large binucleated cells with prominent 'owl-eye' nucleoli surrounded by a clear space, in a background of lymphocytes, eosinophils, and plasma cells. What is the most likely diagnosis?

• A Diffuse large B-cell lymphoma
• B Follicular lymphoma
• C Peripheral T-cell lymphoma
• D Nodular sclerosis Hodgkin lymphoma ✓

Explanation

The binucleated Reed-Sternberg cells with owl-eye nucleoli surrounded by a lacunar space, in a mixed cellular background with eosinophils and plasma cells, are characteristic of Hodgkin lymphoma, specifically the nodular sclerosis subtype—the most common subtype, accounting for 60–70% of cases, with a predilection for young women and mediastinal involvement. B symptoms (fever, night sweats, weight loss) indicate advanced disease and carry prognostic significance.

Reference: Harrison's Principles of Internal Medicine, 21st ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.