A 55-year-old man with HIV infection presents with fever and cervical lymphadenopathy. Biopsy shows a polymorphous infiltrate of plasma cells, eosinophils, and histiocytes containing classical Reed-Sternberg cells that are CD30+, CD15+, CD20-negative, and EBV latent membrane protein 1 positive. Which subtype of classical Hodgkin lymphoma is most likely?

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

Explanation

Mixed cellularity classical Hodgkin lymphoma lacks nodular sclerosis collagen bands, contains abundant inflammatory background cells including plasma cells and eosinophils, shows frequent EBV positivity, and is disproportionately seen in older adults and in HIV-infected patients. Nodular sclerosis is the commonest subtype overall but has lacunar cells, fibrous bands, and lower EBV rates, while lymphocyte-depleted, although also EBV associated and seen in AIDS, shows sheets of RS cells with few reactive cells.

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

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.