Which finding is most characteristic of Hodgkin's disease?

• A. Painful lymphadenopathy
• B. Watery diarrhea
• C. Painless lymphadenopathy
• D. Frequent bone pain

Answer: (C)

Painless lymphadenopathy is the hallmark presentation of Hodgkin lymphoma. The disease characteristically enlarges lymph nodes, often in the neck, in a rubbery, non-tender way because malignant lymphocytes infiltrate and expand the nodes without causing acute inflammatory pain. This painless enlargement can be present for weeks to months and may be accompanied later by systemic B symptoms such as fever, night sweats, and weight loss as the disease progresses.

The other options don’t fit this classic pattern: watery diarrhea isn’t a typical feature of Hodgkin’s disease and points more to GI or infectious processes; frequent bone pain isn’t characteristic unless there’s bone involvement or a different malignancy; painful lymphadenopathy more often suggests an infectious or inflammatory cause rather than Hodgkin lymphoma.