American Board of Internal Medicine (ABIM) Certification Practice Exam

Patients receiving long-term immunosuppressive therapy are at increased risk for developing which malignancy?

1. Hodgkin lymphoma

2. Non-Hodgkin lymphoma

3. Melanoma

4. Breast cancer

The correct answer is: Non-Hodgkin lymphoma

Patients receiving long-term immunosuppressive therapy are at increased risk for developing Non-Hodgkin lymphoma due to the effects of immune suppression on the body. Immunosuppressive therapies, which may be employed for various conditions such as autoimmune disorders or following organ transplants, reduce the body's ability to mount an effective immune response. This immune dysfunction can allow for the unchecked growth of certain types of lymphocytes, which are the cells involved in lymphomas. Non-Hodgkin lymphoma, in particular, has been associated with immunosuppression because it originates from lymphoid tissues, and the immune system's inability to recognize and eliminate malignant cells increases the likelihood of these cancers developing. Furthermore, certain immunosuppressive agents, such as calcineurin inhibitors and steroids, have been shown to increase the risk of lymphoproliferative disorders. In contrast, while Hodgkin lymphoma, melanoma, and breast cancer are serious conditions, they do not have the same strong association with long-term immunosuppressive therapy as Non-Hodgkin lymphoma does. The immune system plays a crucial role in surveilling against multiple types of cancers, but the lymphoproliferative nature of Non-Hodgkin lymphoma directly correlates with the mechanism of