Changes in the size of pelvic lymph nodes in patients being followed after radiotherapy for Hodgkin's disease.
Serial abdominal radiographs of 10 patients who had shown fluctuation in the size of opacified pelvic lymph nodes were reviewed. All had previously been treated for Hodgkin's disease by irradiation alone. Three of the patients studies were finally diagnosed as having recurrent Hodgkin's disease, but the other seven were diagnosed as having reactive change and have remained well without evidence of relapse in the pelvis or abdomen after four years follow-up; one of these patients received quadruple chemotherapy for recurrent disease at the presenting site in the neck. The differential diagnosis of enlarging pelvic lymph nodes in irradiated Hodgkin's patients may be difficult and recurrent lymphoma should not be assumed. Radiologically, reactive change is favoured by the simultaneous enlargement of several groups of nodes, whereas recurrence is favoured by the selective increase in size of solitary or neighbouring lymph nodes. In case of doubt, cytological or histological confirmation of relapse should be sought.
D003937:Diagnosis, Differential; D005500:Follow-Up Studies; D006689:Hodgkin Disease / Q000000981:diagnostic imaging / Q000532:radiotherapy*; D006801:Humans; D006984:Hypertrophy / Q000000981:diagnostic imaging; D008198:Lymph Nodes / Q000473:pathology*; D008220:Lymphography; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging; D010388:Pelvis