A 35-year-old woman presents with fever, lymphadenopathy, and night sweats. Biopsy shows large lacunar cells in a collagen-banded background with inflammatory cells. Which cytogenetic finding is most characteristic of this condition?
- A Gains of 9p24.1 amplifying JAK2 and PDL1 ✓
- B t(14;18) involving BCL2
- C t(15;17) involving PML-RARA
- D t(11;14) involving CCND1
Correct answer: A. Gains of 9p24.1 amplifying JAK2 and PDL1
Explanation
The description — large lacunar cells in a nodular sclerosing background with inflammatory cells — is classic for nodular sclerosing classical Hodgkin lymphoma (cHL). The characteristic molecular finding in cHL is amplification/gain of 9p24.1, which upregulates JAK2 and the immune checkpoint ligands PD-L1/PD-L2, explaining the immunosuppressive tumor microenvironment and the efficacy of PD-1 blockade (pembrolizumab). t(14;18) is follicular lymphoma, t(15;17) is APL, and t(11;14) is 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.