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Hodgkin Lymphoma — RACP Adult Medicine MCQ

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EasyHaematologyHodgkin LymphomaRACP Adult Medicine

A 22-year-old woman presents with a 3-week history of painless cervical lymphadenopathy, night sweats, weight loss, and pruritus. CT shows bilateral cervical, mediastinal, and axillary lymphadenopathy. Lymph node biopsy shows Reed-Sternberg cells (binucleated giant cells with owl-eye appearance) in a background of mixed inflammatory infiltrate. What is the most likely diagnosis?

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Correct answer: D — Hodgkin lymphoma

Painless lymphadenopathy with B symptoms, contiguous nodal spread, and Reed-Sternberg cells on biopsy is Hodgkin lymphoma. It has a bimodal age distribution (20s and >60s). Classical HL subtypes: nodular sclerosis (most common in young adults), mixed cellularity, lymphocyte-rich, and lymphocyte-depleted. Treatment is ABVD chemotherapy ± radiotherapy. Cure rates exceed 85%.

Reference: ALLG – 2024 – Hodgkin Lymphoma; NCCN 2025