Repeat lymphography in children with Hodgkin's disease

Repeat lymphography was performed in 37 children less than 16 years old with histologically proven Hodgkin's disease. The repeat studies had the same lymphatic cannulation success rates as the first lymphogram; one patient had a bilaterally unsuccessful repeat study, which left 36 for analysis. Both first and repeat lymphograms were negative in 33% of children, whereas a negative lymphogram became positive for tumor in 39%. The remaining 28% had a positive first lymphogram, with an equal incidence of positive and negative repeat studies. Reactive hyperplasia was seen in 16.7%, and post-therapeutic lymph node alteration in 22%, of all cases. Of the 22 children studied for routine opacification or because of suspected but unproved relapse, 10 (45%) had positve repeat studies. The repeat lymphogram in these patients was of utmost importance in initiating therapy. Nine of 14 patients studied for documented clinical relapse had positive repeat studies.