Clinico-pathological study of hodgkin's disease in King Abdulaziz university hospital, Jeddah

ABSTRACT

Hodgkin's disease [HD] has unique epidemiological features with diversified pathologies. The aim of this study was to investigate the clinicopathological pattern of HD at King Abdulaziz University Hospital [KAUH], Jeddah. Our results will be compared to those in the literatures. In addition, the relationship between peripheral blood lymphopenia on presentation, and clinical and laboratory variables among HD patients will also be addressed. A total of 81 HD patients were included in this study. The records were analyzed retrospectively from January 1998 through December 2004 and recorded in a structured form. In order to determine the importance of lymphopenia on presentation as a diagnostic marker in HD a comparison was made to a similar number of patients with non-Hodgkin's lymphoma [NHL] after standardization for age, sex and clinical presentation. Moreover, the association between lymphopenia and clinical and laboratory variables were also studied. There were 54 [66.7%] non-Saudi and 27 [33.3%] Saudi patients with a male to female ratio of 1.31. The mean age of the patients was 40.4 years, ranging from [12-82] years with a SD of +/- 18.95. Cervical lymph nodes were the most common finding at the time of presentation. Mixed cellularity was the most frequent pathology followed by nodular sclerosis with prevalence of advanced stages of the disease in 48 [59.2%] and B symptoms 67 [82.7%]. Lymphopenia was seen in 33 patients, 24 [72.7%] of them were above the age of 30. A comparison between Hodgkin's disease and non-Hodgkin's lymphoma regarding lymphopenia, using the same number of patients after standardization for age, sex and presentation did not turn out to be significant [P > 0.05]. Relationship between lymphopenia and other clinical and laboratory variables also did not turn out to be significant with the exception of anemia where the P-value was <0.05. Our data demonstrated that HD is more common among males, mainly at middle age with lack of bimodal age distribution. Cervical lymphadenopathy is a common presenting sign. Similar to other developing countries the mixed cellularity type of HD was the most common type followed by the nodular sclerosis type. Lymphopenia on presentation is common among patients with HD especially above the age of 30. In order to analyze the importance of this finding as a diagnostic marker in HD, a comparison was made to NHL patients but the association was insignificant. The relationship between lymphopenia and anemia among HD patients is significant as compared to other clinical and laboratory variables