Histopathology in Prognosis if Therapy of Lymphocytic Lymphomas 241 



Evaluation of Prognosis and Response to Therapy Based Upon Extra- 

 nodal Tissues 



The great majority of investigations on Hodgkin's disease have been based 

 upon studies of lymph node biopsies because of the availability of this tissue 

 for study without any risk and with a minimum of discomfort to the pa- 

 tient. However, Hodgkin's disease at autopsy affects a wide variety of tissues, 

 especially the spleen, liver, and marrow. Probably if these tissues were more 





a 



» » 



... 



•• *»• • V- x 



,>-y ia:~-'& ' 



Fig. 17-17. Case 17 , Hodgkin's sarcoma (reticulum cell sarcoma?), 

 lymph node. Dominant cell is a reticulum cell (R), occasional 

 small lymphocytes (S), and neutrophils (A 7 ), many mitoses (X), 

 and degenerating cells (D). (X 900) 



readily accessible for microscopic study, there would be fewer investigators 

 who believe in the localized origin of Hodgkin's disease. 



Liver. There are no systematic studies available on the liver in 

 Hodgkin's disease except for those obtained at autopsy. My own material 

 consists of fragmentary and irregular observations. 9, I0, 1:1 - 14 Early in the di- 

 sease the morphologic feature were nonspecific, consisting of a minor degree 

 of portal infiltration and hyperplasia of Kupffer cells. Most of the biopsies 

 were obtained from patients who were seen as diagnostic problems, usually 

 presenting with lever of unknown origin; such patients are identified with 

 a poor prognosis. It has been impossible to evaluate liver biopsy as an index 



