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The surgical pathology of gastrointestinal Hodgkin's disease
Insights
Gastrointestinal Hodgkin's disease (HD) is rare, with only six cases identified between 1953-1990. Diagnosis requires careful histopathologic and immunostaining review due to its rarity.
Area of Science:
- Oncology
- Gastroenterology
- Pathology
Background:
- Hodgkin's disease (HD) rarely involves the gastrointestinal (GI) tract.
- Understanding the presentation and diagnosis of GI HD is crucial.
Purpose of the Study:
- To identify and characterize cases of Hodgkin's disease involving the gastrointestinal tract.
- To evaluate the diagnostic challenges of primary GI HD.
Main Methods:
- Retrospective review of National Cancer Institute surgical pathology files (1953-1990).
- Histopathological reconfirmation and analysis of clinical presentations.
- Identification of primary versus recurrent GI HD.
Main Results:
- Six cases of GI HD were identified, with four primary and two recurrent.
- Primary HD occurred in the stomach (3) and duodenum (1).
- Recurrent HD occurred in the stomach (1) and colon (1). One primary gastric case was a composite lymphoma.
Conclusions:
- Gastrointestinal involvement by Hodgkin's disease is exceptionally rare.
- A diagnosis of primary GI HD should be approached with skepticism.
- Diagnosis relies on classic histopathology and immunostaining, but no single feature is pathognomonic.
Abstract:
The files of the National Cancer Institute were searched for all surgical specimens from the gastrointestinal (GI) tract with the diagnosis of Hodgkin's disease (HD) that were accessioned during the years 1953-1990; six patients with a histologically reconfirmed diagnosis were identified. Of these patients, four presented with GI HD and two had recurrent HD. Primary HD appeared in the stomach (three patients) and the duodenum (one patient); recurrent HD after diagnosis in a conventional nodal site appeared in the stomach (one patient) and the colon (one patient). One of the cases of primary gastric disease was a composite lymphoma consisting of HD and diffuse large cell lymphoma. In view of the rarity of GI tract involvement by HD, a diagnosis of primary GI HD should be viewed with skepticism; support for such a diagnosis may be provided by both classic histopathologic features of HD and immunostaining, but no single feature can be regarded as pathognomonic.