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The Role of Surgery in the Management of Lymphoma

John G. Allison, MD, MBChB, FRCS(Ed), FCS(SA)
JAMA. 1981;246(24):2843-2848. doi:10.1001/jama.1981.03320240051026.
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WITHIN the field of cancer treatment, the most gratifying advances have probably been made in the lymphoma group, especially those of the Hodgkin's type; over the past two decades predicted survival rates have increased dramatically. Newer concepts and understanding of the Hodgkin's group of lymphomas have generated a cautiously optimistic attitude that Hodgkin's disease is eminently curable. Although the hematologistoncologist and radiotherapist bear the brunt of the management, the surgeon can contribute in a meaningful and positive way in both nodal and extranodal disease of all histological types. With this in mind, the classification, staging, and treatment of the lymphomas will be reviewed briefly, as will the role of surgery in the diagnosis, therapy, staging, and post-treatment restaging.

PATHOLOGICAL CLASSIFICATION AND STAGING  The diagnostic feature of Hodgkin's disease is the multinucleated Reed-Sternberg giant cell, with subtyping based on the ratio of other cell types (Table 1). With the exception of


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