A 35-year-old man presents with mediastinal mass, B-symptoms, and biopsy showing large lacunar cells in a collagen-rich stroma. Immunohistochemistry shows CD15+, CD30+, CD45−, CD20−. Which subtype of Hodgkin lymphoma does this represent?

• A Nodular lymphocyte predominant
• B Mixed cellularity
• C Lymphocyte depleted
• D Nodular sclerosis ✓

Explanation

Nodular sclerosis is the most common subtype of classical Hodgkin lymphoma in developed countries, characterised by collagen-band-forming nodules and lacunar cells (retraction artifact of RS cells in formalin-fixed tissue). It has a predilection for the anterior mediastinum and supraclavicular nodes in young adults. Classical RS cells and lacunar cells express CD15 and CD30 but are negative for CD45 and usually CD20.

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

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.