Monitoring the response of lymphoma patients to therapy: correlation of abdominal CT findings with clinical course and histologic cell type.

Abstract

A review was made of 365 abdominal computed tomographic (CT) examinations in 125 patients with a histologic diagnosis of lymphoma who had undergone CT before and after therapy. Clinical correlation immediately preceding the follow-up CT examination was obtained in 100 patients. In these 100 patients, five distinct subgroups emerged: (a) reduction in extent of disease without changes in internal nodal characteristics; (b) reduction in extent of disease with change in internal nodal characteristics; (c) no change in extent of disease and no change in internal nodal characteristics; (d) no change in extent of disease but change in internal nodal characteristics; and (e) disease progression. Changes in internal nodal architecture consisted of diminished attenuation or mesenteric "stranding." A 91% correlation existed between the CT findings and the clinical course. Of those patients with a worsening clinical course, and follow-up CT studies suggesting a stable or improved response to therapy, relapse in the majority (57%) involved the central nervous system. The authors conclude that limited abdominal CT examination is satisfactory in the posttherapy follow-up of lymphoma patients.

Lymphography and Abdominal Computed Tomography in the Staging of Non-Hodgkin Lymphoma

“…Organ involvement (other than liver and spleen) is not uncommon in patients with NHL (9,10,17,19). Seven out of 91 patients in the present series had gastro-intestinal localization of the lymphoma, but in all patients this was known or suggested by physical examination, barium examination or endoscopy prior to staging.…”

Structural changes induced by antineoplastic therapies: keys to evaluate tumor response to treatment

“…b The postchemotherapy follow-up demonstrates the dystrophic calcification of the large lesion and the disappearance of the second one. The serum CA-125 levels became normal marked in those neoplasms histologically marked by a rich connective stroma, as seen in Hodgkin's disease and especially in its nodular sclerosing variant [14,15,16].…”

“…Fibrotic components in a linear arrangement, i.e., mesenteric strands, have been identified in numerous patients after resolution of local lesions treated with chemotherapy [16]. The residual masses demonstrate homogeneous soft tissue density, with mild contrast enhancement [10,18,20].…”

Η Συγκριτικη Αξιολογηση Της Λεμφογραφιας Και Υπολογιστικης Τομογραφια Στη Μελετη Της Νοσου Hodgkin

“…Κι αυτό, γιατί σε χρονικό διάστημα μεγαλύτερο απο 12 μήνες, το σκιαγραφικό που μένει στους λεμφαδένες συνήθως δεν είναι αρκετό για διάγνωση. Αυτό μειώνει την πρακτική αξία της λεμφογραφίας, γιατί συγχρόνως είναι γνωστό, ότι στη νόσο του Hodgkin οι υποτροπές, σε ποσοστό 50%,συμβαίνουν 1 1 /2-5 χρόνια μετά την έναρξη της θεραπείας (1 58) Τότε δηλαδή, που το σκιαγραφικό που έμεινε στους λεμφαδένες από την προηγούμενη λεμφογραφία, δεν είναι αρκετό για διάγνωση Επίσης, σε ασθενείς με λέμφωμα, μετά από θεραπεία,σε σύγκριση που έγινε μεταξύ της υπολογιστικής τομογραφίας και της κλινικής πορείας, το ποσοστό επιτυχίας της πρώτης στην εκτίμηση των αποτελεσμάτων ήταν 100% για τα στάδια II και IV, 86% για το στάδιο Ι, 89% για το στάδιο III και 92% για το στάδιο V (159).…”