What are the advantages of CT for 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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CT is the imaging study of choice for evaluating mediastinal lesions. CT is an excellent modality in determining the exact location of the mediastinal tumor, as well as its relationship to adjacent structures. It is also useful in differentiating masses originating in the mediastinum from those encroaching on the mediastinum from the lung or other structures.

CT can be used to differentiate tissue attenuations, and it is highly accurate in differentiating fluid, fat, and calcification. CT helps in assessing the vascularity of mediastinal tumors. CT is better than other cross-sectional imaging in revealing local invasion of adjacent structures by a mass or intrathoracic metastases. Fat-fluid levels are considered highly specific in diagnosing mediastinal, mature teratomas (though these are uncommon).

Conventional imaging modalities such as CT and MRI can demonstrate only a decrease in lesion size, and the findings are poor predictors of clinical outcome after treatment for lymphoma. On long-term follow-up, less than 50% of patients with positive CT findings have disease relapse or other evidence of residual tumor.

A study by Albano et al found that pulmonary MALT lymphoma is 18F-FDG avid in most cases, 18F-FDG avidity is correlated with tumor size, and single or multiple areas of consolidation are the most common pattern of presentation of lung MALT lymphoma on CT. [2]

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