Abstract
Purpose The hypothesis is tested in 297 patients with Hodgkin's disease, that it does arise in one site and spreads in a predictable manner in the lymphatic system before hematogenous dissemination. Materials and methods 70 PS I, 66 PS II, 137 PS III. and 15 PS IV Hodgkin's disease patients. 188 A, 109 B. 236 presented cervical lymphomas: 80 left-, 92 right- and 64 bilateral-cervical. They were grouped according to the number of involved sites. Results A characteristical pattern was observed in 88%. The accuracy of the hypothesis is significant for the 236 patients with cervical lymphoma (P = 0.01; T-test). Conclusion HD spreads from the right cervical side via the upper me diastinum and hili to the upper abdominal nodes and the spleen whereas left cervical lymphoma leads to direct abdominal involvement bypassing the mediastinum. Abdominal involvement precedes upward spread via the pulmonary hili and upper mediastinum on the left side or on both sides to the cervical or axillary or inguinal nodes.
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