The bone marrow is more frequently involved in Hodgkin's granuloma than is suspected, as is shown by autopsy records. Ziegler found the marrow involved in 40 per cent of the cases, while Symmers noted medullary changes in 7 of 15 cases. These authors observed a proliferation of endothelial cells, fibrosis and, in some areas, an increase in normal cell elements of the bone marrow. Other changes characteristic of Hodgkin's granuloma were present.
Actual destruction of the bone has been reported from time to time with and without roentgenographic evidence. Since the advent of the roentgen rays, groups of cases are available in which the earlier symptoms referable to the bones together with the roentgenograms can be studied, and the progress of the disease followed to its termination.
Of 396 cases registered as Hodgkin's granuloma in the Memorial Hospital, the diagnosis was found to have been confirmed by biopsy