The histological classification recommended at the Rye Conference, “Obstacles to the Control of Hodgkin's Disease,” has been applied to a series of 185 untreated patients subjected to the surgical staging of Hodgkin's disease at Stanford University Medical Center. The useo f consensus findings of a panal of pathologists, in 114 of these cases, has confirmed the applicability and reproducibility of this classification. The pathological findings were correlated with the preoperative clinical evaluation in order to assess the anatomic distribution of lesions. Constancy of the histological pattern in multiple lesions was verified. The nodular sclerosing type was observed in 74% of cases and showed a predilection for the mediastinum (71%) with a high incidence of abdominal involvement (42%). However, the risk of abdominal involvement was greater with mixed cellularity (62%) and lymphocyte predominance (46%) types. Two of 3 patients with lymphocyte depletion had abdominal disease. In striking contrast to the nodular sclerosing type, no patient with lymphocyte predominance showed evidence of mediastinal disease. A high incidence of splenic involvement in patients was noted (42%) including 62% with mixted cellularity, 39% with nodular sclerosis, and 23% with lymphocyte predominance. With the exception of 2 cases of lymphocyte depletion involving the bone marrow and one case of mixed cellular type involving the lung, all other “extranodal” lesions were of the nodular sclerosing type. The anatomic distribution of lesions was unrelated to age or sex.

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Supported by Grant 2 HMZ-620-94 from the John A. Hartford Foundation, Inc., and USPHS Grants CA-08122 and CA-05838 from the National Cancer Institute.

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