Under this term are included a great variety of diseases which may show gross changes similar to those of leukemia, yet with none of the characteristic blood changes. Hodgkin's disease, although an inexact term, has come to signify a condition in which there is a progressive increase in the size of the lymph nodes, particularly the cervical, axillary and mediastinal, with the blood changes present in leukemia. The blood shows a slight diminution in the number of red cells, 3,000,000 to 4,000,000, and a decreased hemoglobin percentage. The leukocytes are slightly increased, averaging about 12,000.

Microscopically the bone-marrow shows a moderate hyperplasia. The lymph nodes undergo some hyperplasia and show areas containing numbers of large cells with a faintly staining cell body and a single large nucleus. Later in the disease will be found necrotic areas surrounded by cells of the epithelioid type and more or less numerous large cells with polymorphic nuclei or with two or more small oval nuclei lying in the center of the cell body. Accompanying this is an increase of the connective tissue. Eosinophile cells are present in the lymph nodes usually in great numbers.

Hodgkin's Disease (Stengel).

Fig. 130. - Hodgkin's Disease (Stengel).

Showing marked enlargement of the glands of the right axilla, with consequent dropsy of the arm; less marked involvement of the submaxillary and cervical lymph-glands.

The cause of this disease is not known. The condition seems to be related, more or less closely, to leukemia and lymphosarcoma. Mallory discards the above terms and refers to pseudo-leukemia and Hodgkin's disease as lymphoblastoma, tumors of mesoblastic origin in which the cells tend to differentiate into lymphocytes, or into cells of the lymphocyte type.