Hodgkin's disease. A clinical and pathologic study of 235 cases.

Abstract

Retrospective clinicopathologic analysis of 235 cases of Hodgkin's disease was performed. Nodular sclerosis most commonly presented in Stages I and II, mixed cellularity and lymphocytic depletion in Stages III and IV, while lymphocytic predominance was evenly distributed. Nodular sclerosis was most common in young females. Mediastinal involvement was commonest for mixed cellularity in early clinical stages. Six-year survival was calculated by the life-table method. Lymphocytic depletion was relatively favorable regardless of clinical stage. Nodular sclerosis was favorable only in Stages I and II, while mixed cellularity and lymphocytic depletion were unfavorable regardless of clinical stage. Poor survival was associated with late stage, male sex, older age, and systemic symptoms. Statistical analysis showed histologic type and clinical stage to be highly significant prognostic factors. Age, sex, and systemic symptoms were weaker prognostic variables. The nodular sclerosis group was pathologically subdivided by cellular composition and degree of fibrosis. Survival advantage was found for cases with mostly lymphocytes, few Sternberg-Reed cells, and least fibrosis. The combined results of the Keller series and our own suggest that subclassification of nodular sclerosis is feasible.