Non‐hodgkin's lymphomas: A clinicopathologic study of 293 cases

Retrospective clinicopathologic study of 293 cases of non‐Hodgkin's lymphomas was performed. Nodularity was quantitatively graded 0 through +4. Higher degrees of nodularity were associated with improved survival. Comparing nodular and diffuse groups, nodularity was associated with improved survival for each cell type except mixed lymphoma. Within nodular and diffuse groups survival advantage was shown to be related to cell type. In NLPD and NM, male sex and systemic symptoms adversely affected survival. In DLPD and DM, advanced clinical stage, old age, and systemic symptoms were associated with poor outlook, sex having no significant effect. In DH, only the absence of systemic symptoms was beneficial; clinical stage, sex, and age showed no effect on the poor outcome. No survival advantage was observed for cases with histologic evidence of nodular fibrosis. Vascular invasion was demonstrated in 18% of nodular and 27% of diffuse lymphomas and was most common in mixed and histiocytic types. However, survival was adversely affected only in histiocytic lymphomas. No direct association between vascular invasion and wide‐spread dissemination was observed. The results suggest that only cases with well developed histologic nodularity have improved survival over diffuse lymphoma, and affirm the prognostic value of the pathologic classification of Rappaport.