Invasion of veins in diagnostic lymh node biopsies from patients with Hodgkin's disease occurs in 6 to 14% of cases studied in reported series. When both spleens and lymph node biopsies obtained at staging operations are examined for vascular invasion, the frequency of the invasion may increase to over 20%, being evident in the spleens of some patients in whom it was not demonstrable in the lymph node biopsies.

Vascular invasion in lymph nodes or spleens of patients with Hodgkin's disease is associated with a high incidence of extranodal organ involvement. Therefore, the detection of vascular invasion in a given patient could be an indication that the disease has spread by the hamatogenous route. Our observations also suggest that hepatic involvement occurs by vascular spread via the splenic vein and the portal system.

Further studies are indicated to determine whether the histological search for vascular invasion should be considered an additional procedure in the assessment of the extent of Hodgkin's disease. Its presence in diagnostic lymph node biopsies, however, does suggest a more extensive involvement than initially evident when the disease belongs to one of the more favorable histological types.


This investigation was supported in part by Grants CA-05183. CA-8970-04, and CA-8971-04 from the National Cancer Isntitute, NIH, USPHS.

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