Nodular Sclerosis Classical Hodgkin Lymphoma in a Young Adult: A Comprehensive Case- Based Review of Pathophysiology, Diagnosis, and Contemporary Management

Classical Hodgkin lymphoma (cHL) is a biologically complex B-cell neoplasm characterized by the presence of malignant Hodgkin and Reed–Sternberg (HRS) cells embedded within a heterogeneous inflammatory microenvironment. We present the case of a 23-year-old male diagnosed with the nodular sclerosis subtype of cHL, who initially presented with painless cervical lymphadenopathy. Histopathological evaluation of bone marrow and cervical lymph node biopsies confirmed CD30-positive neoplastic cells, consistent with cHL. Baseline staging was performed using complete blood counts and PET imaging. The patient underwent first-line chemotherapy with the ABVD regimen (Adriamycin, Bleomycin, Vinblastine, Dacarbazine), accompanied by prophylactic pegylated G-CSF. The treatment was well-tolerated, with no acute adverse events, and the patient was discharged with structured follow-up, infection prophylaxis, and supportive care measures. This case highlights the clinical presentation, diagnostic workflow, and therapeutic management of nodular sclerosis cHL in young adults, illustrating the efficacy of contemporary chemotherapy regimens and the critical role of vigilant supportive care in optimizing patient outcomes.