A 28-year-old woman presents with cervical lymphadenopathy and constitutional B symptoms. Biopsy shows a nodular architecture with a mixed infiltrate of lymphocytes, eosinophils, plasma cells, and scattered large cells with prominent 'owl eye' nucleoli. The background contains bands of fibrosis. This morphology is MOST consistent with which subtype of Hodgkin lymphoma, and what is its most common chromosomal abnormality?

• A Mixed cellularity subtype; trisomy 12
• B Lymphocyte-rich subtype; t(14;18)
• C Nodular lymphocyte-predominant subtype; t(11;14)
• D Nodular sclerosis subtype; gains of chromosome 9p24.1 (JAK2/PD-L1 locus) ✓

Explanation

Nodular sclerosis is the most common Hodgkin lymphoma subtype in young women with mediastinal involvement, characterized by collagen bands dividing the node into cellular nodules, lacunar cells (RS cell variants), and the mixed inflammatory background described. Gains at 9p24.1 amplify JAK2 and PD-L1/PD-L2, explaining both constitutive JAK-STAT signaling and immune evasion. Trisomy 12 is a feature of CLL; t(14;18) drives follicular lymphoma; t(11;14) is the hallmark of mantle cell lymphoma.

Reference: Robbins & Cotran Pathologic Basis of Disease, 10th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.