Hodgkin's lymphoma x ray findings

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sowminya Arikapudi, M.B,B.S. [2]

Overview

Chest, spine, pelvic, and long bone x ray may be helpful in the diagnosis of Hodgkin's lymphoma.

X ray Findings

Chest, spine, pelvic, and long bone x ray may be helpful in the diagnosis of Hodgkin's lymphoma.

Chest x ray

• Pulmonary involvement usually indicates stage IV Hodgkin's lymphoma
• The mediastinal mass ratio can be determined by chest X-ray. A mediastinal mass ratio of greater than 0.33 is consistent with bulky disease.
• The following findings on chest x ray may be suggestive of Hodgkin's lymphoma:

• Masses
• Mass-like consolidation
• Diffuse interstitial thickening
• Sternum may be involved
• Ribs may be osteolytic and expansile
• Bilateral involvement is seen in ~4% of cases
• Mediastinal nodal involvement (Primary disease)
• Pulmonary parenchymal involvement (Recurrent disease)
• Peri bronchial infiltration may sometimes be observed

• 
  Chest x-ray demonstrates widening of the mediastinal outlines and widening of the right para tracheal stripe.
• 
  Lateral projection confirms predominantly anterior mediastinal mass.

Spine x ray

• Erosion of anterior or anterolateral aspect of the vertebral bodies is a classic finding in Hodgkin's lymphoma , caused by enlarged para vertebral lymph nodes
• Nodular sclerosing Hodgkin's lymphoma shows diffusely increased density with our without anterior erosion; vertebral body height is unaffected
• Single, dense vertebra (ivory vertebra) in adults
• Intervertebral disc spaces are generally unaffected by the disease

Pelvic x ray

• Mixed or sclerosing type predominates

Long bones x ray

• Frequently lytic, extending along the long axis of bone through the medullary cavity with endosteal scalloping of the cortex

References

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