A 15-year-old boy presents with a painless, rubbery cervical lymph node of 6 weeks duration, with drenching night sweats and 5 kg weight loss. Excision biopsy shows effacement of nodal architecture by lacunar cells in a background of many eosinophils and sclerotic bands. Which feature of this subtype guides its expected clinical behavior?
- A It tends to present at low stage with a good prognosis ✓
- B It commonly transforms into diffuse large B-cell lymphoma
- C It is associated with HTLV-1 infection
- D It carries the worst prognosis among Hodgkin lymphoma subtypes
Correct answer: A. It tends to present at low stage with a good prognosis
Explanation
Lacunar cells with collagen bands and an eosinophil-rich background define nodular sclerosis Hodgkin lymphoma, the commonest subtype in adolescents. It characteristically involves lower cervical and mediastinal nodes and usually presents at stage I or II, giving it an excellent prognosis with modern therapy. Transformation to diffuse large A-cell lymphoma is a risk of nodular lymphocyte-predominant Hodgkin lymphoma, not this entity. HTLV-1 links to adult T-cell leukemia-lymphoma, and the worst-prognosis subtype is lymphocyte-depleted disease.
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.