A 55-year-old man presents with fever, cervical lymphadenopathy, and night sweats. Biopsy shows large binucleate cells with prominent eosinophilic 'owl-eye' nucleoli on a background of plasma cells, eosinophils, and lymphocytes. The neoplastic cells are CD15+, CD30+, CD45−, and EBV-LMP1+. This morphological subtype of Hodgkin lymphoma most likely carries which WHO classification?

• A Nodular sclerosis Hodgkin lymphoma
• B Lymphocyte-rich classical Hodgkin lymphoma
• C Mixed cellularity Hodgkin lymphoma ✓
• D Lymphocyte-depleted Hodgkin lymphoma

Explanation

Mixed cellularity classical Hodgkin lymphoma features classic Reed-Sternberg cells (large binucleate 'owl-eye' cells) on a heterogeneous background of plasma cells, eosinophils, lymphocytes, and histiocytes without broad fibrous bands. It is strongly associated with EBV (EBER/LMP1 positive) and typically presents in older males and immunosuppressed patients. Nodular sclerosis shows broad collagen bands and lacunar cells; lymphocyte-depleted has few lymphocytes and many RS cells.

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

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.