Small noncleaved cell lymphoma associated with florid epithelioid granulomatous response. A clinicopathologic study of seven patients.

The finding of epithelioid granulomas has been widely reported in solid tumors and in hematologic malignancies. This phenomenon has been especially well studied in Hodgkin's disease, where its presence has been shown to confer a favorable prognosis. Such granulomas have not, however, been as extensively studied in other forms of hematologic malignancy, particularly in small noncleaved cell lymphoma. We report seven cases of small noncleaved cell lymphoma that were associated with a marked epithelioid granulomatous response. Detailed clinical data, including follow-up, were available in five of the seven patients. Three had localized disease (stage I), whereas two had advanced disease (stages III-A and IV-B, respectively). All five patients achieved a complete remission and are alive without evidence of disease (median follow-up, 6 years). These findings suggest that the epithelioid granulomas may be a manifestation of a host response that confers an improved prognosis in this subtype of non-Hodgkin's lymphoma.