Computed tomography versus chest radiography: impact on management of patients with lymphoma

To assess the influence of computed tomography of the thorax (CTT) in management of patients with lymphoma, we compared results of CTT and chest radiography (CXR) for 42 patients (65 examinations) with Hodgkin's disease (HD) with 48 patients (57 examinations) with non-Hodgkin lymphoma (NHL). Six percent (7/122) of all CTs resulted in major changes in patient management (95% confidence interval = 2-12%). In four patients with HD, influential findings included of additional sites of lymphoma and clarification of x-ray results. In three patients with NHL (5%), management was altered as a result of identification of additional sites of lymphoma on CTT. Eleven percent of CTT examinations clarified equivocal CXR findings in NHL, and management was affected in two of these cases. Our findings suggest that CTT is valuable in clarifying equivocal CXR findings, and in staging or restaging patients for whom the detection of mediastinal adenopathy affect patient treatment.