What is the role of CT in thoracic non-Hodgkin lymphoma (NHL) imaging?

Updated: Mar 05, 2019
  • Author: Ali Nawaz Khan, MBBS, FRCS, FRCP, FRCR; Chief Editor: Eugene C Lin, MD  more...
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Answer

Answer

Computed tomography is the preferred imaging method for diagnosing mediastinal, lung parenchymal, and pleural disease (see the images below). Protocols for staging lymphoma include CT scanning of the neck, thorax, abdomen, and pelvis. All mediastinal, lung, thoracic wall, and lung abnormalities (as described in NHL) are better depicted on CT than on conventional radiography. [3, 9, 24, 25, 2] CT is also useful in diagnosing benign mediastinal masses and reliably differentiating from NHL.

Nonenhanced CT scan through the mediastinum shows Nonenhanced CT scan through the mediastinum shows multiple enlarged lymph nodes in the prevascular space, in the right and left paratracheal region. Nodes in the left paratracheal region cause the trachea to be indented and narrowed on the left side. Note the small, bilateral pleural effusion.
Contrast-enhanced axial CT scan in a child shows h Contrast-enhanced axial CT scan in a child shows hypoattenuating, enlarged, subcarinal lymph nodes with splaying of the tracheal bifurcation.
Nonenhanced axial CT scan shows biopsy-proved non- Nonenhanced axial CT scan shows biopsy-proved non-Hodgkin lymphoma (NHL) of the thymus, which appears as a hypoattenuating mass in the anterior mediastinum. Note the tracheal displacement to the right.
An axial CT scan showing an intraparenchymal cavit An axial CT scan showing an intraparenchymal cavitating lung lesion adjacent to the anterior thoracic wall.
Axial CT scans showing superior vena caval obstruc Axial CT scans showing superior vena caval obstruction secondary to lymphadenopathy from NHL.

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