[Secondary solid neoplasms in young patients treated for lymphoproliferative diseases: computed tomography findings]

Diagnostic imaging still plays a key role in the follow-up of oncologic patients. In particular, in hemolymphoproliferative disorders, diagnostic imaging is used to differentiate the complications of integrated treatment from possible relapses. Integrated treatments have lengthened the survival of these patients and therefore such long-term complications as secondary--especially solid--tumors are now more frequently observed. We report on two such cases whose onset followed by 6 and 5 1/2 years the end of the initial treatment: the patients had been cured for acute lymphatic leukemia and Hodgkin's lymphoma. In the leukemia patient, CT and MRI demonstrated a large mediastinal mass, which had been an occasional finding at chest film. CT correctly diagnosed the mass and suggested extrapulmonary and extramediastinal localization, since fat cleavages were normal. MRI allowed better characterization of the mass which was isointense to muscle independent of TR. Disease relapse was excluded and surgery allowed the complete ablation of the ganglioneuroma. In the lymphoma patient, a left hypochondrium mass was supposed as an abdominal relapse from Hodgkin's lymphoma. CT allowed the correct diagnosis of gastric adenocarcinoma to be made on the basis of the mass multifocality and marked enhancement, of the infiltration of liver and hepatogastric ligament lymph nodes and finally of peritoneal involvement. Secondary solid tumors are no remote finding in the follow-up of the patients treated for lymphoproliferative disorders. Diagnostic imaging must allow the differential diagnosis especially from relapses and must use the techniques which are most capable of doing so.