A 35-year-old man presents with rapidly enlarging cervical nodes, fever, and a mediastinal mass. Biopsy shows large cells with pale cytoplasm, prominent nucleoli, and a background of inflammatory cells. CD30+ and CD15+ on IHC; CD20-, EBV-EBER negative. Which translocation is characteristically associated with this entity?

• A t(14;18) BCL2-IGH
• B t(8;14) MYC-IGH
• C t(2;5) NPM1-ALK
• D No recurrent translocation; frequent JAK2 amplification at 9p24.1 ✓

Explanation

The morphology and immunophenotype (CD30+, CD15+, CD20-) describe classic Hodgkin lymphoma (nodular sclerosis or mixed cellularity). Classic HL does not have a single recurrent translocation but characteristically shows amplification/copy gain at 9p24.1 involving JAK2, PD-L1 (CD274), and PD-L2, which drives immune evasion via PD-1 pathway. t(2;5) is ALK+ anaplastic large cell lymphoma; BCL2 translocation is follicular lymphoma; MYC translocation is Burkitt 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.