Assessment of liver and spleen involvement in Hodgkin's disease

Prognosis and proper treatment in Hodgkin's disease (HD) are strictly related to staging accuracy: liver and spleen involvement is of particular importance in this regard. We have evaluated, in 113 consecutive patients, the accuracy of clinical parameters to detect histologically documented HD involvement by comparing hepatosplenomegaly, liver function tests, liver and spleen scan, inspection of liver and spleen surface at laparoscopy with histologic findings. Our data suggest that of all the parameters studied, laparoscopy has the highest sensitivity and specificity values (about 100%). Laparoscopy may precede laparotomy as a staging procedure in HD and may give, in patients not submitted to laparotomy whatever the reasons, very reliable information.