A 45-year-old man presents with pruritis, night sweats, and a mediastinal mass on CXR. Biopsy shows Reed-Sternberg cells positive for CD15 and CD30, negative for CD45. The neoplastic cells are admixed with a mixed inflammatory infiltrate. This represents which histological subtype of Hodgkin lymphoma with the best prognosis?

• A Lymphocyte-rich classical Hodgkin lymphoma ✓
• B Nodular sclerosis Hodgkin lymphoma
• C Mixed cellularity Hodgkin lymphoma
• D Lymphocyte-depleted Hodgkin lymphoma

Explanation

Lymphocyte-rich classical Hodgkin lymphoma carries the best prognosis among all classical HL subtypes due to the abundance of reactive lymphocytes and relative scarcity of Reed-Sternberg cells. Nodular sclerosis is the most common subtype (especially in young women with mediastinal disease), mixed cellularity has intermediate prognosis, and lymphocyte-depleted is the least common with the worst prognosis. The stem describes a classical HL with a mixed infiltrate consistent with mixed cellularity, but the question asks for the best-prognosis subtype.

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

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.