Systemic paediatrics: Hodgkin lymphoma immunophenotype: practice question

A Pediatrics 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.

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Pediatrics · Systemic paediatrics: Hodgkin lymphoma immunophenotype

Sample item

A 14-year-old has painless, firm supraclavicular nodes, fever, drenching night sweats and a widened mediastinum. Excision biopsy shows large binucleate cells with prominent eosinophilic nucleoli in a mixed inflammatory background. Which immunophenotype is expected in the large cells?

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

The answer and the reasoning

D. CD15 and CD30 positive, CD45 negative

Classical Hodgkin lymphoma contains Reed-Sternberg cells that express CD15 and CD30 and are usually CD45 negative. Burkitt lymphoma shows mature B-cell markers, lymphoblastic lymphoma shows TdT, and Langerhans cell histiocytosis expresses CD1a.

Option by option

  • A. TdT and CD3 positive

    TdT with CD3 describes T-lymphoblastic lymphoma, which also presents with a mediastinal mass but has small blasts.

  • B. CD20 and CD10 positive with surface immunoglobulin

    CD20, CD10 and surface immunoglobulin describe Burkitt lymphoma, with a starry sky pattern.

  • C. CD1a positive with Birbeck granules

    CD1a with Birbeck granules defines Langerhans cell histiocytosis.

  • D. CD15 and CD30 positive, CD45 negative (correct)

    Correct. Reed-Sternberg cells are CD15 and CD30 positive and CD45 negative.

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.

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Questions about this Pediatrics question

What is the answer to this Pediatrics question?

The best answer is D, CD15 and CD30 positive, CD45 negative. Classical Hodgkin lymphoma contains Reed-Sternberg cells that express CD15 and CD30 and are usually CD45 negative.

Why is "TdT and CD3 positive" not the answer?

TdT with CD3 describes T-lymphoblastic lymphoma, which also presents with a mediastinal mass but has small blasts.

Why is "CD20 and CD10 positive with surface immunoglobulin" not the answer?

CD20, CD10 and surface immunoglobulin describe Burkitt lymphoma, with a starry sky pattern.

Why is "CD1a positive with Birbeck granules" not the answer?

CD1a with Birbeck granules defines Langerhans cell histiocytosis.

What concept does this question test?

It tests Systemic paediatrics: Hodgkin lymphoma immunophenotype in Pediatrics. Burkitt lymphoma shows mature B-cell markers, lymphoblastic lymphoma shows TdT, and Langerhans cell histiocytosis expresses CD1a.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. 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 Systemic paediatrics: Hodgkin lymphoma immunophenotype?

Memorise milestones and the vaccine schedule as tables and revise them often. Then use the flashcards and the other Pediatrics 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.