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December 7, 1970

To Biopsy or Not to Biopsy

Author Affiliations

Elmira, NY

JAMA. 1970;214(10):1888. doi:10.1001/jama.1970.03180100078023

To the Editor:—  Much discussion in the recent literature concerns Sternberg-Reed cells in tissue sections from patients with conditions other than Hodgkin's disease.1-3 These cases have been especially perplexing in patients with abnormal lymph node proliferations such as infectious mononucleosis, postvaccinal lymphadenitis, and drug-induced lymphoid hyperplasias.Several investigators, faced with differentiating serious, systemic, neoplastic diseases (Hodgkin's type) from those already mentioned, have resorted to nodal biopsy and histologic appraisal. From review of their published photomicrographs, perplexing problems of clinical-pathological differentiation are noted.4As a practicing pathologist, interested in arriving at a rapid, reliable tissue diagnoses to provide definitive therapy, I am hesitant to recommend tissue biopsy in those conditions in which interpretation is difficult even for experienced pathologists and could lead to clinically unnecessary radiation or chemotherapy. It seems that time is the best therapy for those conditions. That is not to say that these patients should be