A 25-year-old male presents with painless cervical lymphadenopathy and B symptoms (fever, night sweats, weight loss). A lymph node biopsy reveals large, binucleated cells with prominent eosinophilic nucleoli, often described as an 'owl's eye' appearance, surrounded by a mixed inflammatory infiltrate. Which of the following is the most likely diagnosis?

Explanation

The clinical presentation (painless lymphadenopathy, B symptoms in a young adult) combined with the characteristic histopathology (large, binucleated cells with prominent eosinophilic nucleoli, resembling 'owl's eyes', surrounded by a mixed inflammatory infiltrate) is pathognomonic for Hodgkin Lymphoma. These cells are known as classic Reed-Sternberg cells. Nodular sclerosis is the most common subtype of Hodgkin Lymphoma, particularly in young adults, and often presents with cervical or mediastinal lymphadenopathy.