A patient presented with fever, night sweats and weight loss. Clinical examination revealed painless lymphadenopathy. Microscopy shows Reed Sternberg cells. Most likely condition is: March 2012
**Core Concept**
The patient's presentation of fever, night sweats, weight loss, and painless lymphadenopathy, along with the presence of Reed Sternberg cells, suggests a diagnosis of a type of lymphoma. This condition is characterized by the abnormal proliferation of lymphocytes, leading to the formation of lymphoid tumors.
**Why the Correct Answer is Right**
The presence of Reed Sternberg cells is a hallmark of Hodgkin lymphoma, a type of cancer that affects the immune system. These cells are large, abnormal lymphocytes that are typically seen in the lymph nodes of patients with Hodgkin lymphoma. The clinical presentation of fever, night sweats, and weight loss, often referred to as B symptoms, is also common in Hodgkin lymphoma. The painless lymphadenopathy is another characteristic feature of this condition, as the lymph nodes are not typically tender or inflamed.
**Why Each Wrong Option is Incorrect**
**Option A:**
This option might be tempting, but it is incorrect because Hodgkin lymphoma is a specific type of lymphoma that is characterized by the presence of Reed Sternberg cells, whereas non-Hodgkin lymphoma is a broader category of lymphomas that can have different clinical and pathological features.
**Option B:**
This option is incorrect because sarcoidosis is a granulomatous disease that can cause lymphadenopathy, but it does not typically present with Reed Sternberg cells or B symptoms.
**Option C:**
This option is incorrect because tuberculosis can cause lymphadenopathy and B symptoms, but it does not typically present with Reed Sternberg cells.
**Option D:**
This option is incorrect because Castleman disease is a rare disorder that can cause lymphadenopathy, but it does not typically present with Reed Sternberg cells or B symptoms.
**Clinical Pearl / High-Yield Fact**
Reed Sternberg cells are a key diagnostic feature of Hodgkin lymphoma, and their presence should prompt further investigation and biopsy to confirm the diagnosis. It's also worth noting that Hodgkin lymphoma can be classified into different subtypes based on the presence of specific cell types, including classical Hodgkin lymphoma and nodular lymphocyte-predominant Hodgkin lymphoma.
**Correct Answer:** C. Tuberculosis