Epidemiologic and histologic patterns of Hodgkin's disease: comparison of the black and white populations of Johannesburg, South Africa.

Histologic patterns of Hodgkin's disease in black and white patients in Johannesburg, South Africa, were studied in relation to sex and age, and compared with each other and with published studies on American, Nigerian, and Ugandan black and American white patients. Pretreatment lymph node biospy specimens from 88 black and 54 white patients were reviewed and histologically subtyped according to the Rye classification. In Johannesburg, black patients have a high frequency of mixed cellular (MC) and lymphocyte depleted (LD) subtypes, and of childhood disease. Male patients predominate in all subtypes including nodular sclerosis (NS) which equals LD in frequency. White Johannesburg patients have a low frequency of childhood disease, an increased rate in young adults, and a relatively high frequency of NS with female patients predominating, although MC is the predominant subtype. Both population groups tend to fall into the intermediate epidemiologic Pattern II, with a bias to Pattern I in black patients, reflecting their poorer socioeconomic condition, and a bias to Pattern III in white patients, reflecting their improved socioeconomic situation.