A 28-year-old woman presents with fever, fatigue, and lymphadenopathy. Biopsy of an enlarged cervical node shows large Reed-Sternberg cells staining positive for CD15 and CD30, negative for CD20 and CD45. PET-CT reveals supra- and infra-diaphragmatic nodal disease with splenic involvement, no extranodal disease. What stage is this Hodgkin lymphoma?
- A Stage IIA
- B Stage IIIB
- C Stage IIIA ✓
- D Stage IVA
Correct answer: C. Stage IIIA
Explanation
The Ann Arbor staging: Stage III = involvement of lymph node regions on both sides of the diaphragm (supra- and infradiaphragmatic). Splenic involvement in Hodgkin lymphoma is considered nodal disease (Stage IIIS) but counts as Stage III since spleen is a lymphoid organ. The suffix A indicates absence of B symptoms (fever >38°C, drenching night sweats, weight loss >10%). There is no extranodal disease to warrant Stage IV. Standard treatment for Stage III HL is ABVD chemotherapy for 6 cycles, with interim PET-guided escalation/de-escalation.
Reference: Harrison's Principles of Internal Medicine, 21st ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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