A 35-year-old woman presents with mediastinal mass, fever, night sweats, and weight loss >10% over 6 months. Biopsy shows Reed-Sternberg cells with CD15+, CD30+, CD45−, CD20− immunophenotype. CT staging reveals disease above and below the diaphragm with splenic involvement but no extranodal disease. What is the Ann Arbor stage?

• A Stage IIB
• B Stage IVB
• C Stage IIA
• D Stage IIIB ✓

Explanation

Ann Arbor staging: Stage III = lymph node involvement on both sides of the diaphragm; splenic involvement is classified as Stage III(S). The B suffix denotes constitutional symptoms (fever >38°C, drenching night sweats, unexplained weight loss >10% in 6 months). There is no extranodal organ involvement, so Stage IV does not apply. The immunophenotype (CD15+, CD30+, CD45−) is classic for classical Hodgkin lymphoma (nodular sclerosis subtype is most common in young women with mediastinal mass).

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

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.