Epithelioid granulomas revisited: long-term follow-up in Hodgkin's disease

A previous retrospective study of epithelioid granulomas discovered in the liver or spleen at staging laparotomy for Hodgkin's disease showed that the granulomas were not indicative of malignant involvement of these organs. Rather, they correlated with improved relapse-free survival in affected patients compared to those without granulomas. These findings were based on 2 year median follow-up. To confirm and expand these findings after additional follow-up, we analyzed the clinical data for 89 of the original cohort of 91 patients who underwent staging laparotomy at our institution between July, 1968 through December, 1972. Neither time to first relapse nor overall survival duration is now significantly different between the granuloma and nongranuloma groups. Of the nongranuloma patients 23/67 (34%) have relapsed versus 3/16 (19%) patients with granulomas (Fisher's exact test p = 0.184). The relapse-free survival advantage for patients with granulomas seen in the earlier report is no longer apparent after more prolonged follow-up.