Haematopathology: diffuse large B cell lymphoma: practice question

A Pathology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Pathology · Haematopathology: diffuse large B cell lymphoma

Sample item

A 62-year-old man has a rapidly enlarging cervical lymph node mass and a raised LDH. Biopsy shows diffuse sheets of large lymphoid cells with nuclei larger than twice a small lymphocyte, a high Ki-67 index and CD20 positivity. Which regimen forms the standard backbone of treatment?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

A. Rituximab with cyclophosphamide, doxorubicin, vincristine and prednisolone

This is diffuse large B cell lymphoma, the commonest aggressive non-Hodgkin lymphoma of adults. The CD20 antigen on the tumour cells is targeted by rituximab, which is combined with CHOP chemotherapy as R-CHOP. Radiotherapy is added selectively for bulky disease.

Option by option

  • A. Rituximab with cyclophosphamide, doxorubicin, vincristine and prednisolone (correct)

    Correct. R-CHOP is the standard first-line regimen for CD20-positive large B cell lymphoma.

  • B. Imatinib mesylate alone

    Imatinib targets BCR-ABL or KIT tyrosine kinases and has no role in this lymphoma.

  • C. Doxorubicin, bleomycin, vinblastine and dacarbazine

    ABVD is the regimen for classical Hodgkin lymphoma, which shows Reed-Sternberg cells.

  • D. All-trans retinoic acid with arsenic trioxide

    ATRA and arsenic trioxide treat acute promyelocytic leukaemia with PML-RARA.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

More Pathology questions

Questions about this Pathology question

What is the answer to this Pathology question?

The best answer is A, Rituximab with cyclophosphamide, doxorubicin, vincristine and prednisolone. This is diffuse large B cell lymphoma, the commonest aggressive non-Hodgkin lymphoma of adults.

Why is "Imatinib mesylate alone" not the answer?

Imatinib targets BCR-ABL or KIT tyrosine kinases and has no role in this lymphoma.

Why is "Doxorubicin, bleomycin, vinblastine and dacarbazine" not the answer?

ABVD is the regimen for classical Hodgkin lymphoma, which shows Reed-Sternberg cells.

Why is "All-trans retinoic acid with arsenic trioxide" not the answer?

ATRA and arsenic trioxide treat acute promyelocytic leukaemia with PML-RARA.

What concept does this question test?

It tests Haematopathology: diffuse large B cell lymphoma in Pathology. The CD20 antigen on the tumour cells is targeted by rituximab, which is combined with CHOP chemotherapy as R-CHOP. Radiotherapy is added selectively for bulky disease.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Haematopathology: diffuse large B cell lymphoma?

Learn each disease as a bundle: cause, key histology, markers, and the clinical hallmark. Then use the flashcards and the other Pathology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.