[Abdominal ultrasound diagnosis of malignant lymphomas]

The abdominal clinical staging in malignant lymphomas should be started from sonography. The size of detectable lymph nodes and focal lesions in liver and spleen (to 0.5 cm on favourable conditions of examination) reflects a comparable position of ultrasound, computed tomography and magnetic resonance imaging. The last called method seems to be advantageous only in the pelvic region. Involved lymph nodes in malignant lymphomas on the contrary to metastatic infiltration in carcinomas appear for the most part hypoechoic. The sonographic findings in liver, spleen, pancreas and kidneys infiltrated by lymphomas and other malignant diseases do not differ significantly. The involvement of gastrointestinal tract can be associated with the so called "bull's eye"-, "target"- or "pseudokidney"-sign. The endoscopic sonography could improve the preoperative staging by measuring thickened gastrointestinal wall structures and by detecting infiltrated neighbouring organs. Ultrasound-assisted needle biopsies are useful. However the favourable results reported (sensitivity, positive correlation, concordance-100%) seems to be connected with low number of cases involved. Remarkable proportion of false negative results should be expected. Laparotomy with splenectomy remains the most accurate staging method in Hodgkin's disease and non-Hodgkin's lymphomas.