A 25-year-old man presents with painless cervical lymphadenopathy. Biopsy shows large lacunar cells in a background of eosinophils, plasma cells, and lymphocytes. Which subtype of Hodgkin lymphoma does this represent and what is its most common presentation pattern?
- A Nodular sclerosis HL; most common subtype, typically young adults with mediastinal involvement ✓
- B Mixed cellularity HL; most common subtype in elderly men
- C Lymphocyte-rich HL; presents with peripheral adenopathy without mediastinal involvement
- D Lymphocyte-depleted HL; most common subtype overall
Correct answer: A. Nodular sclerosis HL; most common subtype, typically young adults with mediastinal involvement
Explanation
Nodular sclerosis is the most common subtype of classical Hodgkin lymphoma, accounting for approximately 60–70% of cases. It characteristically affects young adults, often with mediastinal involvement and cervical lymphadenopathy. The hallmark histology shows lacunar cells (variants of Reed-Sternberg cells) set in a background of fibrotic bands and mixed inflammatory cells including eosinophils. Mixed cellularity is the second most common subtype.
Reference: Harrison's Principles of Internal Medicine, 21st ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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