ENVIRONMENTAL-POLLUTION AND MALIGNANT-LYMPHOMAS - A TENTATIVE CONTRIBUTION TO GEOGRAPHIC PATHOLOGY

The present study reports of the geographic distribution of 2,878 case s of uniformly classified malignant lymphomas and of 2,349 similar cas es from the literature. Data on histological entities are compared wit h the geographic and socio-economic characteristics of the regions whe re they preferentially occur. The results provide three patterns in ly mphoma distribution: small cell lymphocytic lymphomas are frequent amo ng populations of European extraction and in farming rather than indus trial regions. Lymphomas derived from cells of the germinal center are seen preferentially in so-called <<underdeveloped countries>>, and la rge cell (immunoblastic) lymphomas appear rather characteristic of ind ustrial areas. Besides genetic influences (rare chronic lymphocytic le ukemia (CLL) in Asia as compared to Europe), the results suggest envir onmental cofactors in the pathogenesis of malignant lymphomas. CLL is more frequent in areas with rather low-dose chronic toxic influences s uch as from the use of fertilizers and pesticides in farming. Germinal center cell lymphomas tend to occur more frequently in countries with nutritional and hygienic deficiencies with frequent infectious diseas es. Large cell high malignancy lymphomas apparently prefer highly indu strialized regions with pollution of water supplies by more toxic and immunosuppressive substances.