Significance of focal involvement of lymph nodes for the diagnosis and staging of Hodgkin's disease

Six cases of Hodgkin's disease in which lymph node biopsy sections demonstrated only minute foci of Hodgkin's disease are presented. The lymph node sections showed an essentially preserved nodal architecture and a cellular composition that in most areas was not suggestive of Hodgkin's disease. It is our intention to emphasize the need for careful examination of lymph node sections in which clues suggesting early involvement of a lymph node by Hodgkin's disease can be found. This is of great importance in both diagnosis and staging of the disease. The focal obliteration of subcapsular sinuses, the finding of foci of inflammatory cells, the discovery of atypical, malignant‐appearing histiocytes, and an increase in the deposition of collagen, occasionally in a band‐like fashion, should alert the pathologist to search for conclusive evidence of focal involvement of a lymph node by Hodgkin's disease.