What is the role of angiography 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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Lymphomatous tissue is generally hypervascular, but angiography is seldom used in the diagnosis of NHL. With the widespread availability of multidetector-row CT scanners, CT angiography (CTA) is becoming increasingly feasible .

Radiation therapy to the thorax is a risk factor for coronary artery disease. [34] Patients with radiation-induced atherosclerosis are typically young and often have lesions involving the coronary ostia and the left anterior descending artery. Frequently, the best method of revascularization is coronary bypass. Because patients tend to be young, the use of arterial conduits is considered to be superior to the employment of venous grafts. However, the internal thoracic arteries may be caught in the radiation beam and may contain atheromas; hence, they may be unavailable for coronary artery revascularization. To show these changes, preoperative angiography is an essential prerequisite in these patients. [35, 36]

Angiography has little, if any, role in the diagnosis of NHL. Angiography is invasive but is still regarded as a criterion standard in imaging the heart and major blood vessels. However, angiography is being challenged by magnetic resonance angiography (MRA) and CTA.

Lymphomatous deposits may be hypovascular. In rare cases, false-negative results may also occur in the differentiation of aneurysms associated with laminar intraluminal thrombus from other mediastinal masses. The sensitivity and specificity of angiography in the diagnosis of aortic aneurysms are 85% and 95%, respectively.

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