[Value of abdominal CT scan in the staging of malignant lymphoma]

A series of 60 patients with malignant lymphoma was proved by pathology except two with mediastinal lesions. All were admitted for radiotherapy from Oct, 1979 to June 1983 and the abdomen was scanned by CT. There were 29 cases of Hodgkin's disease (HD) and 31 of non-Hodgkin's lymphoma (NHL). The age ranged from 8 to 69 years 5 were scanned before, 32 during and 23 after treatment. The results showed that 18 patients had subdiaphragmatic lesions, of which 10 were HD and 8 NHL. The sites of the 18 positive abdominal scan were 9 lymphatic involvement (para-aortic, coeliac, splenic-hilar, mesenteric, gastric, hepatic-hilar, diaphragmatic posterior group and presacral) and 3 visceral involvement (liver, spleen and adrenal gland). As to the change in clinical staging of malignant lymphoma after CT scan, 5 patients (26%) with stage I were downed to stages II and III; 6 (22%) with stage II to stages III, IV and 1 stage III to stage IV. Altogether 22% of stages I, II and III were down staged. According to our experiences, abdominal CT scan can not take the place of exploration or lymphography because the small lesions in the spleen and liver are not visible on the CT scans using conventional intravenous water soluble contrast media. Lymphography is more accurate in showing the retroperitoneal lymph nodes. The CT scan is valuable in detecting lesions in the upper para-aortic, mesenteric, splenic-hilar, hepatic-hilar and renal-hilar lymph nodes.(ABSTRACT TRUNCATED AT 250 WORDS)