Histologic progression in non-Hodgkin's lymphoma.

We retrospectively evaluated the clinical course and biopsy specimens from 51 5 consecutive non-Hodgkin s lymphoma patients in an attempt to determine the clinical importance of documented changes in histology over time. Two-hundred and five of these patients had an initial diagnosis of nodular lymphoma and were reviewed for this analysis. Sixty-three underwent a repeat biopsy greater than 6 mo after initial diagnosis. In 23 patients. these repeat biopsies revealed a change in histology to a diffuse pattern and/or a change to a larger “histiocytic” cell type. while repeat biopsies for the other 40 (63%) disclosed persistence of a nodular pattern and no clear change in basic cell type. Progression from nodular lymphoma to diffuse histiocytic. mixed. or undifferentiated types of lymphomas of Rappaport was found in repeat biopsies obtained from 1 9 patients (30%). Prognosis for survival following a biopsy that demonstrated histologic change