[Unrecognized Hodgkin's disease as cause of death. A review of 27 cases diagnosed post mortem].

The purpose of the study was to examine the incidence of unrecognised Hodgkin's disease (HD) as cause of death and to search for clinical features that could have ensured a correct pre-mortem diagnosis. A review of cases of HD reported to the Danish Cancer Registry from 1976 through 1987 in patients younger than 70 years old disclosed 27 where HD was the primary cause of death and the diagnosis was unrecognised at the time of death. The majority of the patients had no concurrent diseases and may have benefitted from a correct diagnosis and a potentially curative treatment. Most of the patients had persistent unexplained fever and weight loss. Pancytopenia, hepatic involvement, bone marrow involvement, advanced stage disease, and lymphocytic depletion histology were also frequent findings. Peripheral or retroperitoneal lymphadenopathy was noted in nine patients without biopsy. The many uncommon features of HD together with the frequent findings of falsely negative chest X-ray, bone marrow examination, liver biopsy, and abdominal ultrasound contributed to the difficulty in diagnosis. However, in about 1/3 of the patients clinical findings suggestive of lymphoma did not result in relevant diagnostic procedures.