1979 Volume 20 Issue 11 Pages 1482-1491
An autopsied case of nodular sclerosis (Hodgkin's disease with terminal leukemic change) is reported. A 53-year-old man had a high fever 3 months before admission. After 2 cervical lymph node biopsies, the patient was diagnosed as having nodular sclerosis (Hodgkin's disease). Based on the results of lymphangiography, a 67Ga-tumor scan, a liver biopsy, a bone marrow biopsy, and other clinical examinations on July 12, 1977, he was determined as being at stage Ib. Cervical and supraclavicular lesions were treated with radiation (4,000 rads), and the results were positive. Five months after diagnosis, he suffered from fever, hepatosplenomegaly, and pancytopenia. He was admitted again on May 15, 1978. Some Hodgkin's cells were found in a bone marrow smear, and he was detemined as being at stage IVb. OPP therapy was given, but the response was negative. Two days before his death, Hodgkin's cells (7%) were found in a routine peripheral blood smear. He died on March 29, 1978. Autopsy revealed lymphadenopathy and hepatosplenomegaly, with marked infiltration and proliferation of Hodgkin's cells and Reed-Sternberg's cells. These changes were also seen in the bone marrow, pancreas, lungs, etc. Hodgkin's disease with leukemic change is summarized, and whether nodular sclerosis, which had been thought to have a good prognosis, may develop to leukemic change or not, are discussed.
