Epithelioid granulomas in Hodgkin disease. A favorable prognostic sign?
M. J. O'Connell, S. C. Schimpff, R. H. Kirschner, A. B. Abt and P. H. Wiernik
Histologic sections of spleen and liver prepared from tissue obtained
during exploratory laparotomy and splenectomy in 91 untreated patients with
Hodgkin disease were reviewed to assess the incidence and possible
implications of noncaseating, epitheliod, sarcoid-like granulomas. The 17
patients with granulomas and the 74 patients without granulomas did not
differ appreciably with respect to pretreatment indexes. All patients were
observed for at least 15 months following laparotomy or until the time of
death (range, 15 to 67 months; median, 25 months). The 17 patients with
granulomas tended to have fewer relapses, longer survival, and lower
incidence of subsequent herpes zoster infection compared to the 74 without
granulomas. The presence of epithelioid granulomas in association with
Hodgkin disease may reflect a host response to the tumor with favorable
prognostic implications.
