A 45 years old female patient presented painless supraclavicular lymphadenopathy. Biopsy revealed binucleated acidophilic owl eye appearance with floating lymphocytes in empty space, which were CD 15, CD 30 positive. What is the most probable diagnosis?
**Core Concept**
The patient's presentation of painless lymphadenopathy and specific immunohistochemical markers points towards a diagnosis of a lymphoproliferative disorder, specifically a type of non-Hodgkin lymphoma.
**Why the Correct Answer is Right**
The "owl eye" appearance of the lymphocytes, coupled with the presence of binucleation and floating lymphocytes in an empty space, suggests Reed-Sternberg cells, a hallmark of Hodgkin lymphoma. The positivity for CD15 and CD30 further supports this diagnosis, as these markers are typically expressed on Reed-Sternberg cells. Hodgkin lymphoma is characterized by the presence of these malignant cells within a background of reactive lymphocytes, which may explain the patient's lymphadenopathy.
**Why Each Wrong Option is Incorrect**
**Option A:** This option is incorrect as it does not accurately describe the histological features and immunophenotype of the patient's lymphoma. Lymphoblastic lymphoma typically presents with a different immunophenotype and histological features.
**Option B:** This option is incorrect as it does not accurately describe the histological features and immunophenotype of the patient's lymphoma. Follicular lymphoma typically presents with a different immunophenotype and histological features, such as a follicular pattern and positivity for B-cell markers.
**Option C:** This option is incorrect as it does not accurately describe the histological features and immunophenotype of the patient's lymphoma. Anaplastic large cell lymphoma typically presents with a different immunophenotype and histological features, such as large anaplastic cells and positivity for CD30.
**Option D:** This option is incorrect as it does not accurately describe the histological features and immunophenotype of the patient's lymphoma. Mantle cell lymphoma typically presents with a different immunophenotype and histological features, such as a nodular pattern and positivity for B-cell markers.
**Clinical Pearl / High-Yield Fact**
The presence of Reed-Sternberg cells in a lymph node biopsy is a classic feature of Hodgkin lymphoma, and their positivity for CD15 and CD30 can help differentiate this condition from other types of lymphoma. It is essential to carefully evaluate the histological features and immunophenotype of the lymphoma to make an accurate diagnosis.
**Correct Answer:** D. Hodgkin lymphoma.