Oncology: Hodgkin lymphoma: practice question

A General Medicine question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

Try it

General Medicine · Oncology: Hodgkin lymphoma

Sample item

A 22-year-old man has painless cervical lymphadenopathy, drenching night sweats, pruritus and an 8 kg weight loss over 3 months. A node biopsy shows binucleate cells with prominent owl-eye nucleoli in a mixed inflammatory background. What is the typical immunophenotype of these cells?

ACD5 and CD23 positiveBTdT and CD10 positiveCStrong CD20 and CD45 positive, with CD15 and CD30 negativeDCD15 and CD30 positive, CD45 negative

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. CD15 and CD30 positive, CD45 negative

Binucleate Reed-Sternberg cells in a reactive background define classic Hodgkin lymphoma, which stains CD15 and CD30 and is usually CD45 and CD20 negative. The strongly CD20-positive variant with popcorn cells is nodular lymphocyte-predominant Hodgkin lymphoma. Classic disease is treated with ABVD-based chemotherapy with or without radiotherapy.

Option by option

A. CD5 and CD23 positive
CD5 with CD23 is the profile of chronic lymphocytic leukaemia.
B. TdT and CD10 positive
TdT with CD10 is the profile of precursor lymphoblasts in acute lymphoblastic leukaemia.
C. Strong CD20 and CD45 positive, with CD15 and CD30 negative
That profile describes lymphocyte-predominant Hodgkin lymphoma or a B-cell non-Hodgkin lymphoma.
D. CD15 and CD30 positive, CD45 negative (correct)
Correct. Reed-Sternberg cells are CD15 and CD30 positive and lack CD45.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

Questions about this General Medicine question

What is the answer to this General Medicine question?

The best answer is D, CD15 and CD30 positive, CD45 negative. Binucleate Reed-Sternberg cells in a reactive background define classic Hodgkin lymphoma, which stains CD15 and CD30 and is usually CD45 and CD20 negative.

Why is "CD5 and CD23 positive" not the answer?

CD5 with CD23 is the profile of chronic lymphocytic leukaemia.

Why is "TdT and CD10 positive" not the answer?

TdT with CD10 is the profile of precursor lymphoblasts in acute lymphoblastic leukaemia.

Why is "Strong CD20 and CD45 positive, with CD15 and CD30 negative" not the answer?

That profile describes lymphocyte-predominant Hodgkin lymphoma or a B-cell non-Hodgkin lymphoma.

What concept does this question test?

It tests Oncology: Hodgkin lymphoma in General Medicine. The strongly CD20-positive variant with popcorn cells is nodular lymphocyte-predominant Hodgkin lymphoma. Classic disease is treated with ABVD-based chemotherapy with or without radiotherapy.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Oncology: Hodgkin lymphoma?

For each disease know the classic presentation, the best test, and the first-line treatment. Then use the flashcards and the other General Medicine questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.