A 14-year-old boy presents with painless, firm cervical lymphadenopathy for 6 weeks, drenching night sweats, and weight loss of 4 kg. Chest radiograph shows a lobulated anterior mediastinal mass. Lymph node biopsy reveals binucleate cells with prominent eosinophilic nucleoli against a background of mixed inflammatory cells. These diagnostic cells are derived from which origin?
- A Mature T lymphocytes
- B Cortical thymic epithelial cells
- C Germinal center B lymphocytes ✓
- D Follicular dendritic cells
Correct answer: C. Germinal center B lymphocytes
Explanation
Binucleate cells with prominent eosinophilic nucleoli are Reed-Sternberg cells, diagnostic of Hodgkin lymphoma. Molecular studies show they derive from germinal center B lymphocytes that have lost typical B-cell marker expression while retaining CD30 and often CD15 positivity. The adolescent age group, B symptoms, and anterior mediastinal mass are classic. Cortical thymic epithelium relates to thymoma, mature T cells to peripheral T-cell lymphoma, and follicular dendritic cells to a distinct rare sarcoma.
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.