Dr. Shahrier Amin

Resident PGY4

Case Three

Overview

Clinical history: A 26-year-old male presents with an enlarged lymph node in the left neck. An excisional biopsy was performed.

Microscopic Description: The sections show nodules of lymphoid tissue separated by thick fibrous bands. The nodules are composed of a mixed inflammatory infiltrate made up of lymphocytes, plasma cells, eosinophils and neutrophils. There are also numerous large cells that are morphologically consistent with classic, mononuclear and lacunar variants of Reed-Sternberg cells.

Immunohistochemistry shows the large cells to be positive for CD15, CD30 and Pax-5. They are negative for CD3, CD20, CD45, CD68 and EBV.

The morphology and immunophenotype are in keeping with a Hodgkin lymphoma, nodular sclerosing type.

What is the most probable diagnosis?


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