Residual fibrous masses in treated Hodgkin's disease

Of nine patients with residual masses following therapy for Hodgkin's disease (HD), eight had nodular sclerosing HD, and one had mixed cellularity HD. One patient had Stage II disease, seven had Stage III, and one had Stage IV. Seven patients presented with bulky mediastinal disease. Regardless of the initial therapy used residual masses in the mediastinum and/or peripheral locations stabilized in 1 to 8 months. Between 5 and 10 months after initiation of therapy, five patients underwent resection of mediastinal or paratracheal masses; three patients had resection of peripheral masses, and one patient underwent laparatomy. Microscopically, the resected masses were hyalinized tissue showing a characteristic nodular configuration without evidence of active HD. Stable residual mass lesions occurring after therapy for HD should not be assumed to represent recalcitrant malignancy, as they may show only fibrosis.