The role of abdominal computed tomography in lymphoma following treatment

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Abstract
A total of 206 patients with biopsy-proven lymphoma, 74 with Hodgkin''s disease and 132 with non-Hodgkin''s lymphoma had abnormal computed tomography [CT] for assessment of remission status (108 patients) or for investigation of relapse (98 patients). In 43 patients with diffuse large cell lymphomas scanned at a time of apparent complete remission CT was abnormal in 21. Sixteen of these patients have relapsed and died. Only 1 patient has relapsed in the group who have normal CT scans. This difference was significant (P = 0.00001). This difference was not seen in nodular lymphomas. There were very few patients with Hodgkin''s disease in whom the CT scan was abnormal; many abnormalities following treatment may represent inactive Hodgkin''s disease or fibrosis only. CT played a major role in diagnosing the full extent of relapse in non-Hodgkin''s lymphoma and Hodgkin''s disease. Over 50% of the abnormal sites detected by CT would not have been shown by any other non-invasive investigation. Five patients with treated Hodgkin''s disease who had B symptoms only suggesting relapse were all shown by CT to have extensive intra-abdominal disease.