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Recurrent Hodgkin's disease after bone marrow transplantation
I Shahab1, J P Greer, T A Beeker
1Department of Pathology, Vanderbilt University Medical Center, Nashville, Tennessee 37232-5310, USA.
American Journal of Clinical Pathology
|January 1, 1997
Summary
Histologic features of recurrent Hodgkin's disease (HD) after bone marrow transplantation (BMT) are similar to original biopsies. The lung is the most common extranodal recurrence site post-BMT.
Area of Science:
- Hematology
- Oncology
- Pathology
Background:
- Recurrent Hodgkin's disease (HD) after conventional therapy is well-documented.
- Limited data exists on the histologic characteristics of HD recurrence following bone marrow transplantation (BMT).
Purpose of the Study:
- To analyze the histologic features of nodular sclerosing Hodgkin's disease (NSHD) recurrence after BMT.
- To compare post-BMT recurrent HD histology with original diagnostic and pre-BMT specimens.
Main Methods:
- Histologic examination of biopsy specimens from 63 patients with recurrent HD post-BMT.
- Detailed analysis of original, pre-BMT, and post-BMT specimens from eight patients.
- Immunoperoxidase studies (CD30) on paraffin-embedded tissues.
Main Results:
- Thirteen of 63 patients (20.6%) had histologically confirmed recurrent HD post-BMT.
- Seven patients had recurrent NSHD, with lymph nodes and lung being common sites.
- Post-BMT lung recurrence showed increased sclerosis and fibroblastic features.
- One patient developed high-grade non-Hodgkin's B-cell lymphoma post-BMT.
- Phenotypic changes in Reed-Sternberg cell variants were minimal in most post-BMT specimens.
Conclusions:
- Histologic findings of recurrent NSHD after BMT are generally similar to original diagnostic and pre-BMT specimens.
- The lung is the predominant extranodal site for post-BMT HD recurrence.
- Rare development of secondary malignancies, such as non-Hodgkin's lymphoma, can occur after BMT for HD.