A 30-year-old woman presents with mediastinal mass, fever, night sweats, and 12 kg weight loss over 4 months. Biopsy of a cervical node shows Reed-Sternberg cells in a cellular background of eosinophils, plasma cells, and lymphocytes with fibrotic bands. What subtype of Hodgkin's lymphoma is this?
- A Mixed cellularity (MCHL)
- B Nodular sclerosis (NSHL) ✓
- C Lymphocyte-rich classical HL
- D Nodular lymphocyte-predominant HL (NLPHL)
Explanation
Nodular sclerosis Hodgkin's lymphoma (NSHL) is the most common subtype, typically affecting young women and presenting with a mediastinal mass. Histologically it is characterised by collagen bands dividing the lymph node into nodules and lacunar Reed-Sternberg cell variants on a background of eosinophils, plasma cells, and lymphocytes. Mixed cellularity HL shows a more heterogeneous background without fibrosis and is more often EBV-associated. NLPHL features 'popcorn' or LP (lymphocytic-predominant) cells, lacks classic RS cells, and is CD20+/CD15-. Lymphocyte-rich HL is rare and associated with a good prognosis.
Reference: Harrison's Principles of Internal Medicine, 21st ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.