Haematology: mixed cellularity Hodgkin lymphoma: practice question

A Pathology 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

Pathology · Haematology: mixed cellularity Hodgkin lymphoma

Sample item

A man with advanced HIV infection is diagnosed with Hodgkin lymphoma. Reed-Sternberg cells lie in a mixed background of eosinophils, plasma cells and histiocytes, and EBV-encoded RNA is detected in the large cells. Which subtype is most likely?

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

The answer and the reasoning

D. Mixed cellularity

Mixed cellularity Hodgkin lymphoma is the subtype most often EBV-positive and is frequent in older patients, in resource-limited settings and in HIV infection. Its polymorphous background of eosinophils, plasma cells and histiocytes is characteristic.

Option by option

  • A. Nodular sclerosis

    Nodular sclerosis shows collagen bands and lacunar cells and is usually EBV-negative.

  • B. Nodular lymphocyte predominant

    Nodular lymphocyte predominant disease has popcorn cells, a B-cell phenotype and is EBV-negative.

  • C. Lymphocyte rich

    Lymphocyte rich disease has a background predominantly of small lymphocytes rather than eosinophils and plasma cells.

  • D. Mixed cellularity (correct)

    Correct. A polymorphous background and EBV positivity in an HIV patient indicate mixed cellularity.

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.

More Pathology questions

Questions about this Pathology question

What is the answer to this Pathology question?

The best answer is D, Mixed cellularity. Mixed cellularity Hodgkin lymphoma is the subtype most often EBV-positive and is frequent in older patients, in resource-limited settings and in HIV infection.

Why is "Nodular sclerosis" not the answer?

Nodular sclerosis shows collagen bands and lacunar cells and is usually EBV-negative.

Why is "Nodular lymphocyte predominant" not the answer?

Nodular lymphocyte predominant disease has popcorn cells, a B-cell phenotype and is EBV-negative.

Why is "Lymphocyte rich" not the answer?

Lymphocyte rich disease has a background predominantly of small lymphocytes rather than eosinophils and plasma cells.

What concept does this question test?

It tests Haematology: mixed cellularity Hodgkin lymphoma in Pathology. Its polymorphous background of eosinophils, plasma cells and histiocytes is characteristic.

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 Haematology: mixed cellularity Hodgkin lymphoma?

Learn each disease as a bundle: cause, key histology, markers, and the clinical hallmark. Then use the flashcards and the other Pathology 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.