CLASSIFICATION OF HODGKINS-DISEASE BIOPSIES BY A PANEL OF 4 HISTOPATHOLOGISTS - REPORT OF 1,140 PATIENTS FROM THE GERMAN NATIONAL TRIAL

First results from reviewing the diagnostic biopsies of Hodgkin's lymp homas (HL) are reported. Biopsies from 1,140 patients were evaluated b y consensus diagnoses according to an extended classification of the B ritish National Lymphoma Investigation. 95 of the recruited cases (8.3 %) were omitted and not approved as Hodgkin's lymphoma. The remaining 1,045 biopsies were classified as follows: Lymphocytic predominance 31 (2.7%); Nodular sclerosis (NS) 660 (57.9%), Mixed cellularity (MC) 15 9 (13.9%); Lymphocytic depletion 8 (0.7%); unclassifiable Hodgkin's 14 8 (13.0%). The unproved Hodgkin's cases [95 (8.3%)] were divided into non-Hodgkin's lymphomas 32 (1.9%), uncertain due to inadequate techniq ues 32 (2.8%), borderline between Hodgkin's- and Non-Hodgkin's lymphom a 23 (2.0%). Major dissent on this question involved 17 cases (1.5%) a nd 1 case which was non-malignant. All unclassifiable, borderline or d issent cases were reassessed after the histologic techniques were impr oved, and immunophenotyping and clinical data reevaluated. The rate of agreement among the observers was about 81.6%, varying between 23.8% in grade 2 NS to 85.0% in both NS groups. Only 62.8% of all primary di agnoses were approved by the final diagnoses of the panel. Important d ifferences in the classification of the British National Lymphoma Inve stigation concerns the NS-group and mainly its grade 2 subtype. MC was identical in both classifications. Clinico-pathologic correlation of actuarial survival times revealed a significantly worse outcome of MC vs NS, <20% after 80 months observation. Only slightly significant bet ter survivals were found in grade 1 vs grade 2 NS. Significant differe nces in unclear compared to all Hodgkin's, were found and the worst su rvival was in the NHL group.