Chest ImagingLymphoma recurrence, thoracic
tends to occur at the initial site of localized disease site. In
Hodgkins disease (
HD), recurrence is usually seen close to the radiation treatment port margins in the adjacent untreated areas of the lung. Radiologically, recurrence appears as
nodular opacities or mass lesions in the lung, or as ill-defined parahilar opacities. Enlargement of paracardiac or diaphragmatic
lymph nodes manifested radiographically as a mass of the cardiophrenic angle is also a relatively common feature of recurrence because these nodes are not included in the mantle radiation treatment field (
Fig.1). Recurrence in previously irradiated intrathoracic
lymph nodes, although uncommon, may occur, particularly in patients with initial large
mediastinal masses.
In patients with intermediate and high-grade non Hodgkins lymphomas (NHL), tumour tends to recur at the initial localized disease site. Most of these patients present with recurrence within 2 years of completion of treatment. CT shows an increase in size of one or more masses.
In both HD and NHL, recurrences in the chest wall are better depicted by using MRI.
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CT scan in a patient previously treated by mantle radiation for Hodgkin's disease (HD) showing necrotic enlarged paracardiac lymph nodes, reflecting recurrence of lymphoma.
(From Grenier P., Imagerie Thoracique de lAdulte. Flammarion, Paris, France, 1996, with permission.)
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Lymphoma recurrence, thoracic, Fig.1 | |