ODULAR SCLEROSIS (NS) is a distinctive pathologicN subtype of Hodgkin's disease (HD) that is characterized by a nodular growth pattern, intranodal collagen band formation, and the presence of lacunar cells.'-4 NS does not coexist with or transform into other pathologic subtypes of HD.'-' This has led to the proposition that "the classification of NS takes precedence over other histological types which appear to be present in the same section."' NS is the most commonly recognized histopathologic subtype of HD in many studies.'-I3 In the clinical trials of HD conducted by the British National Lymphoma Investigation (BNLI),I4 75% of the cases were classified as NS. The cellular nodules of NS may show a wide variety of cytologic appearances which range from a predominance of lymphocytes to lymphocyte depletion with numerous Hodgkin's cells.8 Since the first publication by Cross,'' there have been several reports attempting to correlate pathologic features with prognosis in NS.'6-24 The results have been generally inconclusive, largely due to the relatively small number of cases included. This prompted us to undertake a histologic review of the diagnostic lymph node biopsy spec-

Objective Numerous investigators have theorized that postoperative changes in Alzheimer's disease neuropathology may underlie postoperative neurocognitive disorders. Thus, we determined the relationship between postoperative changes in cognition and cerebrospinal (CSF) tau, p‐tau‐181p, or Aβ levels after non‐cardiac, non‐neurologic surgery in older adults. Methods Participants underwent cognitive testing before and 6 weeks after surgery, and lumbar punctures before, 24 h after, and 6 weeks after surgery. Cognitive scores were combined via factor analysis into an overall cognitive index. In total, 110 patients returned for 6‐week postoperative testing and were included in the analysis. Results There was no significant change from before to 24 h or 6 weeks following surgery in CSF tau (median [median absolute deviation] change before to 24 h: 0.00 [4.36] pg/mL, p = 0.853; change before to 6 weeks: −1.21 [3.98] pg/mL, p = 0.827). There were also no significant changes in CSF p‐tau‐181p or Aβ over this period. There was no change in cognitive index (mean [95% CI] 0.040 [−0.018, 0.098], p = 0.175) from before to 6 weeks after surgery, although there were postoperative declines in verbal memory (−0.346 [−0.523, −0.170], p = 0.003) and improvements in executive function (0.394, [0.310, 0.479], p < 0.001). There were no significant correlations between preoperative to 6‐week postoperative changes in cognition and CSF tau, p‐tau‐181p, or Aβ42 changes over this interval (p > 0.05 for each). Interpretation Neurocognitive changes after non‐cardiac, non‐neurologic surgery in the majority of cognitively healthy, community‐dwelling older adults are unlikely to be related to postoperative changes in AD neuropathology (as assessed by CSF Aβ, tau or p‐tau‐181p levels or the p‐tau‐181p/Aβ or tau/Aβ ratios). Trial Registration: http://clinicaltrials.gov (NCT01993836).

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