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Lymphangiography, ultrasonography, and computed tomography in hodgkin's disease and non-hodgkin's lymphoma

  • Melvin E. Clouse
    Correspondence
    Addres reprint requests to: Melvin E. Clouse, MD, Department of Radiology, New England Deaconess Hospital, 185 Pilgrim Road, Boston, Massachusetts 02215.
    Affiliations
    From the Departments of Radiology, New England Deaconess Hospital and Harvard Medical School, Boston, Massachusetts, USA

    Nassau County Medical Center, East Meadow, New York, USA
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  • Dewey A. Harrison
    Affiliations
    From the Departments of Radiology, New England Deaconess Hospital and Harvard Medical School, Boston, Massachusetts, USA

    Nassau County Medical Center, East Meadow, New York, USA
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  • Clement J. Grassi
    Affiliations
    From the Departments of Radiology, New England Deaconess Hospital and Harvard Medical School, Boston, Massachusetts, USA

    Nassau County Medical Center, East Meadow, New York, USA
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  • Philip Costello
    Affiliations
    From the Departments of Radiology, New England Deaconess Hospital and Harvard Medical School, Boston, Massachusetts, USA

    Nassau County Medical Center, East Meadow, New York, USA
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  • Sally Ann Edwards
    Affiliations
    From the Departments of Radiology, New England Deaconess Hospital and Harvard Medical School, Boston, Massachusetts, USA

    Nassau County Medical Center, East Meadow, New York, USA
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  • Hugh G. Wheeler
    Affiliations
    From the Departments of Radiology, New England Deaconess Hospital and Harvard Medical School, Boston, Massachusetts, USA

    Nassau County Medical Center, East Meadow, New York, USA
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      Abstract

      Findings from histologic analysis, lymphangiography, ultrasonography, and computed tomography were reviewed for 54 cases of Hodgkin's disease and 18 cases of non-Hodgkin's lymphoma. All patients were classified as clinical stage 1 or 2 disease at the time of the imaging studies. The ultrasound and computed tomography studies identified only 30 to 40% of the truly positive patients. This low sensitivity contrasts with lymphangiography, which identified 95% of the truly positive Hodgkin's disease patients and 70% of the patients with abdominal spread of non-Hodgkin's lymphoma. Many errors in interpretation were attributable to location and distribution of disease in these patients and the differing patterns of spread in Hodgkin's disease and non-Hodgkin's lymphoma. The evidence indicates that when findings are positive on computed tomography or ultrasound, no other study is necessary. In stage 1 or 2 lymphoma, non-Hodgkin's patients with negative noninvasive findings and all Hodgkin's patients, regardless of their noninvasive findings, should undergo lymphangiography.

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