LYMPHOCYTE-DEPLETION HODGKINS-DISEASE - A RETROSPECTIVE ANALYSIS OF 35 CASES

The pathological material of 35 patients with Hodgkin's disease lympho cyte-depletion type (type 4) is reviewed with an immunohistochemistry study on paraffin-embedded sections. The new pathologic data are compa red with clinical features. These 35 patients are 4.7% of 742 previous ly untreated patients managed in this institution from 1960 to 1991. T he diagnosis of 31 of the 35 patients was rectified, 17 to non-Hodgkin 's lymphoma (12 unclassifiable and five anaplastic Ki-1 positive) and 14 to another type of Hodgkin 's disease (six nodular sclerosis and e ight mixed cellularity). In four cases, the pathologic material was ne ither sufficient nor satisfactory to allow a clear-cut distinction bet ween Hodgkin's disease and non-Hodgkin's lymphoma. The analysis of cli nical data before and after pathological revision did nor show airy di fference in clinical features, either between Hodgkin 's disease ''typ e 4'' and other types (I, 2 or 3) or between cases with Hodgkin's dise ase and those with non-Hodgkin's lymphoma. There is, however, a signif icant male predominance for Hodgkin's disease versus non-Hodgkin's lym phoma (P = 0.029, exact Fisher test), and B symptoms in non-Hodgkin's lymphomas (P = 0.056), whereas B symptoms nr e commonly seen in advanc ed stages of Hodgkin's disease. It is emphasized that all Hodgkin's di sease of lymphocyte-depletion type should be reviewed and discussed be fore any treatment, and this diagnosis actually means non-Hodgkin's ly mphoma or other types of Hodgkin Hodgkin 's disease.