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Hodgkin Lymphoma — RACP Adult Medicine MCQ

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ModerateHaematologyHodgkin LymphomaRACP Adult Medicine

A 55-year-old man presents with a 3-month history of drenching night sweats, 8 kg weight loss, and painless cervical lymphadenopathy. Biopsy shows Reed-Sternberg cells in a mixed cellularity background. PET-CT shows involvement above and below the diaphragm with no B symptoms other than night sweats. What is the Ann Arbor stage?

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Correct answer: E — Stage IIIB

Lymph node involvement above AND below the diaphragm constitutes stage III disease. B symptoms (fever >38°C, night sweats, weight loss >10% in 6 months) classify it as 'B'. Night sweats count as a B symptom. Therefore this is stage IIIB Hodgkin lymphoma (mixed cellularity subtype). Standard treatment for advanced-stage HL is ABVD (doxorubicin, bleomycin, vinblastine, dacarbazine) or escalated BEACOPP for high-risk disease.

Reference: eTG – 2025 – Haematology; NCCN – 2025 – Hodgkin Lymphoma Guidelines