Hodgkin's disease involving Waldeyer's ring: A study of four cases

We report four casts of Hodgkins disease who presented with involvement of Waldeyer's ring. Their clinical, morphological and immunohistochemical feat ures are discussed. The patients were immuno-competent, were between 17 and 65 years of age and presented with symptoms related to swelling in the nas opharynx or oropharynx and cervical lymphadenopathy. The nasopharyngeal bio psy and the cervical lymph node in all four cases showed features of classi cal Hodgkin's disease. The Reed Sternberg cells expressed CD15 and CD30, an d in three cases, CD20 and Epstein-Barr virus - latent membrane protein -1 (EBV-LMP-1). Extranodal involvement by Hodgkin's disease which is not in co ntinuity with nodal disease is rare in immunocompetent patients. Morphologi cally, such extranodal lesions, especially in locations like the oropharynx and nasopharynx. should be differentiated from EBV-associated lymphoprolif erations.