Intrathoracic manifestations of lymphoma detected by CT

Abstract

Introduction : Computed tomography (CT) has been frequently supplemented to stage intrathoracic disease, monitor response to treatment, evaluate recurrence, and diagnose complications. Geographic variations in the incidence of malignant lymphoma are well documented. However, there is no radiologic study of intrathoracic disease of lymphoma in Thailand.

Objective : To describe intrathoracic diseases of both Hodgkin disease (HD) and non-Hodgkin’s lymphoma (NHL) demonstrated on CT.

Setting : King Chulalongkorn Memorial Hospital

Research design : A retrospective study Patients Lymphoma

patients : who obtained chest CT as an initial staging in between January and December 2003.

Methods : We reviewed chest CT obtained as an initial staging within 1 month either before or after diagnosis of lymphoma patients. Each chest CT was reviewed by a chest radiologist.

Results : A total of 62 patients of lymphoma met inclusion criteria (39 men, 23 women; mean age, 46.6 years); 9 were HD and 53 were NHL. Intrathoracic diseases were present in 6 of 9 patients with HD and in 38 of 53 patients of NHL. In HD, 5 had enlarged nodes; 1 had lung involvement; 3 had pleural effusions; 2 had pericardial effusion, and one had distant bone lesion. In NHL, 30 had enlarged nodes; 4 had lung involvement; 28 had pleural abnormalities; 6 had pericardial effusion; 1 had cardiac involvement and distant bone lesion each.

Conclusions : The incidence of intrathoracic involvement of HD and NHL is approximately 70% and the most common intrathoracic manifestation is nodal enlargement. The most common nodal group involved in HD is anterior mediastinal group whereas in NHL is paratracheal group.