False statement regarding Hodgkin’s disease is: September 2009
First, I need to remember the key facts about Hodgkin's disease. It's a type of lymphoma characterized by the presence of Reed-Sternberg cells. The disease has a bimodal age distribution, with peaks in young adults and older adults. Staging is done using the Ann Arbor system. Treatment often involves chemotherapy and radiation, and prognosis is generally good compared to non-Hodgkin's lymphoma.
Now, common false statements might include things like being more common in older adults only (but it has a bimodal distribution), or that it's more aggressive than non-Hodgkin's. Another could be about the presence of specific markers like CD20, which is more for non-Hodgkin's. Also, maybe a false statement about the treatment approach or staging criteria.
The correct answer here is likely a statement that contradicts these facts. For example, if an option says "Hodgkin's disease is more common in males than females," that's actually true. But if an option claims "Hodgkin's lymphoma is typically CD20 positive," that's false because Reed-Sternberg cells are usually CD15 and CD30 positive, not CD20. CD20 is a marker for B-cell lymphomas, but Reed-Sternberg cells are derived from B-cells but lose CD20 in Hodgkin's.
Another possible false statement is about the staging system. The Ann Arbor system uses stages I to IV and adds letters for bulky disease or extranodal involvement. So if an option says "Staging is done by the Cotswold system," that's incorrect. The Cotswold modification adds letters like A, B, E, etc., but the main system is Ann Arbor.
Also, prognosis: if an option says "Poor prognosis with advanced stages," that's true. But if it says "Hodgkin's has a worse prognosis than non-Hodgkin's," that's false because Hodgkin's usually has a better prognosis.
So the correct answer here would be the option that states a false fact about CD20 positivity, staging system, or distribution. Let's structure the explanation accordingly.
**Core Concept**: Hodgkin's lymphoma is a malignancy characterized by Reed-Sternberg cells, with bimodal age distribution. It is distinct from non-Hodgkin lymphomas in histology, markers, and treatment. Key features include CD15/CD30 positivity and the Ann Arbor staging system.
**Why the Correct Answer is Right**: The false statement likely involves CD20 positivity. Reed-Sternberg cells lack CD20 (a B-cell marker expressed in many non-Hodgkin lymphomas), making CD20-targeted therapies like rituximab ineffective in Hodgkin's. This is a critical diagnostic and therapeutic distinction.
**Why Each Wrong Option is Incorrect**:
**Option A**: "Hodgkin's lymphoma has a bimodal age distribution." *Correct fact; peaks in 15β35 years and >55 years.*
**Option B**: "Ann