Histopathologic and Immunocytochemical Study of Hodgkin's Disease

ABSTRACT

Hodgkin's disease primarily involves the lymphoreticular system with characteristic tumor cells and infiltration of reactive lymphocytes, eosinophils and plasma cells. The present study investigates the incidence of the disease by subtypes and by geographic differences, its clinicopathologic features and properties of the tumor cells. Fifty-eight cases were retrospectively reviewed, and the results were as follows; 1) Histopathologic classification by the Rye modification were; lymphocyte predominance(LP) 4 cases, nodular sclerosis (NS) 12 cases, mixed cellularity (MC) 26 cases and lymphocyte depletion(LD) 16 cases 2) The geographic difference in the distribution of subtypes of Hodgkin's disease between the Seoul and Wonju areas was noted and in Seoul, the ratio of NS was higher than in Wonju, and the ratio of LD was higher in Wonju than in Seoul 3) Age distribution was between 6 and 7O years with a mean age of 37 years. The peak incidence was seen between the 3rd and 5th decades. The male to female ratio was 2.91 with 43 male patients and 15 female 4) Utilizing the Ann Arbor staging method, 75-87.5% of LP, MC and NS were classified as stage I or II and 81.3% of LD were stage III or IV 5) The initial biopsy sites most commonly seen were in the peripheral lymph nodes (54 cases) and one case each in the mediastinal lymph node, thymus, tonsil and stomach 6) The most frequent initial chief complaint was a palpable mass (60.3%), other complaints included fever, cough, dyspnea, anorexia general weakness and hematemesis 7) Among 58 cases, 32 cases were studied using an immunoperoxidase stain. The Reed-Stemberg (R-S) cells and/or Hodgkin's cells were positive for Kappa and Lambda light chains, simultaneously. One case was positive for lysozyme and all were negative for S-100 protein. For the (C)u-antichymotrypsin, 13 cases exhibited a positive reaction. These findings suggest that R-S cells might be the histiocytic origin.