Skip to main content
SpringerLink
Log in

Die Lymphogranulomatose im heutigen Obduktionsgut

Morbus Hodgkin in autopsies today

  • Published:
Zeitschrift für Krebsforschung und Klinische Onkologie Aims and scope Submit manuscript

Summary

In Hodgkin's disease, good clinical results are obtained by the modern combined treatment with irradiation and chemotherapy. An examination of autopsy findings show in the period 1955–1964 a mean survival time (measured from first biopsy until death) of 22 month, in the period 1965–1973 of 42 month. In contrast to first biopsies, autopsies have a prevalence to the reticular “Hodgkin-sarcoma”. 41% of all cases are of this type. 12 of these cases had changed from the lymphocytic predominaut type or from nodular sclerosis, to the reticular type. This augmentation of the reticular type is seen as a consequence of modern therapy. In 18 autopsies, histologic classification was rendered impossible by massive scarring. 8 cases of the period 1965–1973 did not show any lymphogranulomatous tissue and could be morphologically defined as “cured”. Therapeutic damages were found in 25 cases. 6 cases had diffuse pulmonary fibrosis. The therapy provoked scars could be differentiated histologically from the hyalinizations occurring in nodular sclerosis and in diffuse fibrosis.

Zusammenfassung

Beim Morbus Hodgkin werden durch die moderne Kombinationsbehandlung mit Bestrahlung und Chemotherapie gute klinische Resultate erzielt. Im Obduktionsgut betrug die mittlere Überlebenszeit (gerechnet von der bioptischen Diagnose bis zum Tode) 1955–1964 22 Monate, 1965–1973 42 Monate. Im Gegensatz zur Erst-Biopsie steht bei den Autopsien das reticuläre „Hodgkin-Sarkom” im Vordergrund. 41% der Todesfälle weisen diesen Typ auf. 12 Fälle hatten sich vom lymphocytenreichen Typ bzw. von der nodulären Sklerose in den reticulären Typ verwandelt. Die Zunahme des reticulären Typs wird als Folge der modernen Therapie aufgefaßt. Bei 18 von 100 Obduktionen war wegen massiver Vernarbung eine histologische Klassifikation nicht mehr möglich. 8 Fälle aus den Jahren 1965–1973 zeigten keinerlei Lymphogranulomatosegewebe mehr. Sie sind morphologisch als „geheilt” zu bezeichnen. Therapieschäden fanden wir in 25 der 100 Fälle. Auffallend waren 6 diffuse Lungenfibrosen. Histologisch sind die therapiebedingten Narben zu unterscheiden von den Hyalinisierungen bei nodulärer Sklerose und diffuser Fibröse.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

Literatur

  • Arseneau,J.C., Sponzo,R.W., Levin,Dl., Schnipper,L.E., Bronner,H., Young,R.C., Canellos,G.P., Johnson,R.E., de Vita,V.T.: Nonlymphomatous malignant tumours complicating Hodgkin's disiase. New Engl. J. Med. 287, 1119–1122 (1972)

    Google Scholar 

  • Berard,C.W., Thomas,L.B., Axtell,L.M., Kruse,M., Newell,G., Kagan,R.: The relationship of histopathological subtype to clinical stage of Hodgkin's disease at diagnosis. Cancer Res. 31, 1776–1785 (1971)

    Google Scholar 

  • Brunner,K.W.: Die Therapie der lymphatischen Systemerkrankungen. Dtsch. Ges. inn. Med. 79, 168–184 (1973)

    Google Scholar 

  • Butler,J.J.: Relationship of histological findings to survival in Hodgkin's disease. Cancer Res. 31, 1770–1775 (1971)

    Google Scholar 

  • Canellos,G.P., Young,R.C., Berard,C.W., DeVita,V.T.: Combination chemotherapy and survival in advenced Hodgkin's disease. Arch. intern Med. 131, 388–390 (1973)

    Google Scholar 

  • Carbone,P.P., Kaplan,H.S., Musshoff,K., Smithers,D.W., Tubina,M.: Report of the committee on Hodgkin's disease staging classification. Cancer Res. 31, 1860–1861 (1971)

    Google Scholar 

  • Correa,P., O'Conor,G.T., Berard,C.W., Axtell,L.M., Myers,M.H.: International comparability and reproducibility in histologie subclassification of Hodgkin's disease. J. nat. Cancer Inst. 50, 1429–1435 (1973)

    Google Scholar 

  • DeVita,V.T., Serpick,A.A., Carbone,P.P.: Combination chemotherapy in the treatment of advenced Hodgkin's disease. Ann. intern Med. 73, 881–895 (1970)

    Google Scholar 

  • Eger,W., Gregl,A.: Die Strahlenpneumonitis. Stuttgart: Hippokrates-Verlag. 1965

    Google Scholar 

  • Fransilla,K.O., Kalima,T.V., Voutilainen,A.: Histologic classification of Hodgkin's disease. Cancer 20, 1594–1601 (1976)

    Google Scholar 

  • Frei,E.: Status and perspectives in chemotherapy of Hodgkin's disease. Arch. intern Med. 131, 439–445 (1973)

    Google Scholar 

  • Fülle,H.H., Pribilla,W.: Explorative Laparotomie und Splenektomie bei Lymphogranulomatose. Schweiz. med. Wschr. 104, 413–420 (1974)

    Google Scholar 

  • Gross,R.: Fortschritte in der Chemotherapie von Tumoren. Verh. dtsch. Ges. inn. Med. 78, 93–105 (1972)

    Google Scholar 

  • Grundmann,E., Pritzsche,R.: Zur Pathologie des behandelten Morbus Hodgkin. Dtsch. med. Wschr. 99, 269–273 (1974)

    Google Scholar 

  • Jackson,H.jr., Parker,F.jr.: Hodgkin's Disease and allied disorders. New York: Oxford University Press 1947

    Google Scholar 

  • Hamann,W., Oehlert,W., Musshoff,K., Nuss,A., Schnellbacher,B.: Histologische Einteilung des Lymphoma malignum Hodgkin und seine Bedeutung für die Prognose. Dtsch. med. Wschr. 95, 112–117 (1970)

    Google Scholar 

  • Hunstein,W.: Tumorinduktion durch Cytostatica beim Menschen. Rec. Res. Cancer Res. 1975 (im Druck)

  • Kaplan,H.S.: Hodgkin's disease. Cambridge, Massachusetts: Harvard University Press, 1972

    Google Scholar 

  • Lennert,K.: Aufgeforderte Diskussionsbemerkung zu R. J. Lukes (Histopathology of Hodgkin's disease). Z. Krebsforsch. 78, 137–139 (1972)

    Google Scholar 

  • Levitan,R., Diamond,H.D., Craver,L.F.: Liver in Hodgkin's disease. Gut 2, 60–71 (1961)

    Google Scholar 

  • Lukes,R.J., Craver,L.F., Hall,T.C., Rappaport,H., Rubin,P.: Report of the nomenclature committee. Cancer Res. 26, 1311 (1966)

    Google Scholar 

  • Lukes,R.J.: The pathologic manifestations of Hodgkin's disease. Z. Krebsforsch. 78, 129–136 (1972)

    Google Scholar 

  • Mitrou,P.S., Fischer,M., Martin,H.: Unreifzellige Leukämien im Krankheitsverlauf des Morbus Hodgkin. Dtsch. med. Wschr. 99, 1596–1597 (1974)

    Google Scholar 

  • Moore,M.R., Bull,J.M., Jones,S.E., Rosenberg,S.A., Kaplan,H.S.: Combined radiotherapy and chemotherapy in the treatment of Hodgkin's disease. Submitted for publication. Persönliche Mitteilung 1972

  • Musshoff,K., Oehlert,W., Hamann,W., Nuss,A.: Klinik, Pathologie und Therapie von Patienten mit geheiltem Morbus Hodgkin. Klin. Wschr. 47, 1175–1176 (1969)

    Google Scholar 

  • Musshoff,K.: Prognostic and therapeutic inplications of staging in extranodal Hodgkin's disease. Conference on Staging in Hodgkin's disease. Ann. Arbor. April 26–28, 1971. Cancer Res. 31 1814–1827 (1971)

    Google Scholar 

  • Musshoff,K., Slanina,J.: Stadieneinteilung der malignen Lymphome. Klin. Wschr. 52, 109 bis 117 (1974)

    Google Scholar 

  • Patchefsky,A.S., Brodovsky,H., Southard,M., Menduke,H., Gray,St., Hoch,W.S.: Hodgkin's disease. Cancer 32, 150–161 (1973)

    Google Scholar 

  • Peters,M.V.: Prophylactic treatment of adjacent areas in Hodgkin's disease. Cancer Res. 26, 1232–1243 (1966)

    Google Scholar 

  • Peters,M.V.: The need for a new clinical classification in Hodgkin's disease: Keynote address. Cancer Res. 31, 1713–1722 (1971)

    Google Scholar 

  • Remmele,W.: Arzneischäden am Knochenmark. Verh. dtsch. Ges. Path. 56, 291–310 (1972)

    Google Scholar 

  • Schmidt,C.G.: Klinik und Chemotherapie der Lymphogranulomatose. Z. Krebsforsch. 78, 140–161 (1972)

    Google Scholar 

  • Schubert,G.H., Lagemann,K., Wolf,K.-J.: Das pathologisch-anatomische Substrat streifenförmiger Zeichnungen der Lungen bei Lymphogranulomatose. Dtsch. med. Wschr. 98, 1323–1333 (1973)

    Google Scholar 

  • Strum,S.B., Rappaport,H.: Persistence of Hodgkin's disease in long-term survivors. Amer. J. Med. 51, 222–240 (1971)

    Google Scholar 

  • Strum,S.B., Hutchison,G.B., Park,J.K., Rappaport,H.: Further observations on the biologic significance of vascular invasion in Hodgkin's disease. Cancer 27, 1–6 (1971)

    Google Scholar 

  • Uddströmer,M.: On the occurrence of lymphogranulomatosis (Sternberg) in Sweden, 1915 bis 1931 and some considerations as to its relation to tuberculosis. Acta tuberc. scand. Supp. 1, 1–225 (1934)

    Google Scholar 

  • Ultmann,J.E.: Clinical features and diagnosis of Hodgkin's disease. Cancer 19, 297–307 (1966)

    Google Scholar 

  • Ultmann,J.E.: Current status: The management of lymphoma. Sem. Hemat. 7, 441–460 (1970)

    Google Scholar 

  • Ultmann,J.E., Moran,E.M.: Clinical course and complications in Hodgkin's disease. Arch. intern. Med. 131, 332–353 (1973)

    Google Scholar 

  • Westling,P.: Studies of the prognosis in Hodgkin's disease. Acta Radiol 245, 5–125 (1965)

    Google Scholar 

  • Wüst,G., Janssen,W.: Einfluß der Therapie auf den Übergang von Lymphogranulomatose in Sarkom. Münch. med. Wschr. 41, 1395–1397 (1956)

    Google Scholar 

  • Wuttke,H.: Lymphogranulomatose mit Toxoplasmose-Encephalitis. Dtsch. med. Wschr. 99, 1689–1691 (1974)

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Pathologisches Institut der Universität Münster i. Westf., Germany

    E. Grundmann & R. Fritzsche

Authors
  1. E. Grundmann
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. R. Fritzsche
    View author publications

    You can also search for this author in PubMed Google Scholar

Additional information

Herrn Prof. Dr. Dr. h. c. Herwig Hamperl zum 75. Geburtstag gewidmet.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Grundmann, E., Fritzsche, R. Die Lymphogranulomatose im heutigen Obduktionsgut. Z. Krebsforsch. 83, 7–26 (1975). https://doi.org/10.1007/BF00284398

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF00284398

Search

Navigation