A 30-year-old man presents with painless cervical lymphadenopathy. Biopsy shows large binucleated Reed-Sternberg cells with prominent 'owl-eye' nucleoli in a background of eosinophils, plasma cells, and lymphocytes. Flow cytometry shows CD15+, CD30+, CD45−, CD20− phenotype. According to WHO 2022 classification, which specific variant of classical Hodgkin lymphoma shows the WORST prognosis?
- A Nodular sclerosis
- B Lymphocyte-depleted ✓
- C Mixed cellularity
- D Lymphocyte-rich
Correct answer: B. Lymphocyte-depleted
Explanation
Lymphocyte-depleted classical Hodgkin lymphoma (LD-cHL) carries the worst prognosis; it is the rarest subtype, occurs in older/immunocompromised patients, and presents with advanced stage disease. Histologically it shows abundant RS cells with paucity of reactive lymphocytes. The phenotype CD15+/CD30+/CD45−/CD20− is shared by all cHL subtypes. Nodular sclerosis is the most common in young women. Lymphocyte-rich has the best prognosis among cHL subtypes.
Reference: Robbins & Cotran Pathologic Basis of Disease, 10th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.