Which condition is characterized by painless lymphadenopathy with mediastinal involvement?

• A. Hodgkin's disease
• B. Chronic lymphocytic leukemia
• C. Hairy cell leukemia
• D. Multiple myeloma

Answer: (A)

Painless lymphadenopathy with mediastinal involvement is classic for Hodgkin lymphoma. This disease often presents as painless enlarged lymph nodes, and mediastinal adenopathy is a common finding on chest imaging, especially in younger patients. The diagnosis is supported by the presence of Reed-Sternberg cells on biopsy.

Chronic lymphocytic leukemia can show lymph node enlargement but typically occurs in older adults and lymphadenopathy is not characteristically confined to the mediastinum. Hairy cell leukemia tends to present with splenomegaly and cytopenias rather than prominent mediastinal lymphadenopathy. Multiple myeloma mainly causes bone pain, anemia, hypercalcemia, and renal issues, with lymphadenopathy being uncommon.