Detection of liver involvement in Hodgkin's disease

Liver involvement with Hodgkin's disease is determined at our institution by a combination of wedge biopsy and needle biopsy at the time of staging laparotomy. This retrospective study was undertaken to determine whether the wedge or the needle biopsy method is the more accurate. All staging laparotomies (n = 116) during the period 1972-1986 were reviewed. Twelve patients were found to have liver involvement with Hodgkin's disease; 2 had had wedge biopsies only and ten had had both wedge and needle biopsies. In all ten with both wedge and needle biopsies, the wedge biopsies were positive for liver involvement, but in only five were the needle biopsies positive. This study indicates that wedge biopsy is the more accurate method for detecting liver involvement in these patients, and we believe it should always be a part of the staging laparotomy for Hodgkin's disease.