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The most likely diagnosis in this patient is Hodgkin lymphoma. The biopsy demonstrates a Reed-Sternberg cell, a classic finding in Hodgkin lymphoma that is CD15+ and CD30+.
In this patient with systemic symptoms and lymphadenopathy, lymphoma should be high on the differential diagnosis. The presence of a Reed-Sternberg cell on histology further suggests that this patient likely has Hodgkin lymphoma. Hodgkin lymphoma is a neoplasm of large B cells (Reed-Sternberg cells) that are CD15+ and CD30+. These cells secrete pro-inflammatory cytokines and create a large inflammatory cell infiltrate. Clinically, Hodgkin lymphoma presents with classic “B symptoms” like unexplained fever, chills, night sweats, and weight loss. The prognosis of Hodgkin lymphoma is determined by the lymphocyte:Reed-Sternberg cell ratio – the more lymphocytes present per Reed-Sternberg cell, the better the prognosis.
Figure A demonstrates the classic histologic appearance of Hodgkin lymphoma. Note the presence of the large Reed-Sternberg cell with “owl-eyed” nuclei in a background of inflammatory cells.
Answer 1: CD3 is a T-cell-specific marker that is part of the T-cell receptor complex. It is not found on B-cells.
Answer 2: CD4 is a T-cell-specific marker that serves as a co-receptor for the T-cell receptor by binding to the class II major histocompatibility complex (MHC) molecule. It is found exclusively on helper T cells and is not found on B-cells.
Answer 3: CD8 is a T-cell-specific marker that serves as a co-receptor for the T-cell receptor by binding to the class I major histocompatibility complex (MHC) molecule. It is found exclusively on cytotoxic T-cells and is not found on B-cells.
Answer 4: CD16 is a low-affinity Fc receptor found on the surface of natural killer (NK) cells. Binding of CD16 to the Fc portion of IgG antibodies activates NK cell antibody-dependent cell-mediated cytotoxicity. CD16 is not found on B-cells.
Hodgkin lymphoma is a B-cell neoplasm that is characterized by CD15+/CD30+ Reed-Sternberg cells and presents with "B symptoms" such as fever, chills, and night sweats.
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