Differences in presentation of Hodgkin's disease in Sudan and Western countries

A retrospective study was performed dealing with clinical and histopathological aspects of Hodgkin's disease in patients presenting to the Radiation and Isotopes Centre of Khartoum (RICK) during the period from January 1984 to January 1989. A total of 105 patients were studied; this number accounted for 30.6% of all lymphoma patients and 2.0% of all cancers seen at RICK during the same period. The median age was 30 yrs, and the majority of patients were within two age groups, above 25 yrs and above 50 yrs, demonstrating a bimodal pattern. Males were commonly affected and this was more marked in children (M:F = 4.7:1.0). Two striking differences are observed between this study and those from the western world. The first was the high incidence of late clinical stages (III,IV) (70%) in this series despite the moderate duration of symptoms. The second was predominance of mixed cellularity and lymphocytic predominant sub-groups (65%) compared to reports from the western world. A possibility of a chronic stimulatory process of the lymphatic system is raised. The high incidence of late clinical stages on presentation with favourable histological types needs more work.