Vascular invasion and hematogenous dissemination of Hodgkin's disease

The clinical records and pathologic material of 125 Hodgkin's disease patients consecutively admitted to the Baltimore Cancer Research Center for staging laparotomy were reviewed. Diagnostic lymph node biopsies from 91 of these patients studied for evidence of vascular invasion revealed 4 biopsies that were positive (4.4%). The course of the disease in these patients has not been distinguished by extranodal dissemination or shortened survival. In contrast, vascular invasion in the spleen, present in 7 of 44 spleens involved by Hodgkin's disease (16%), was associated with hepatic and bone marrow metastases, early relapse, and shortened survival. The results indicate that while vascular invasion in diagnostic lymph node biopsies may not have prognostic implications, the presence of vascular invasion in the spleen is an ominous sign.