Hodgkin's and Non-Hodgkin's Lymphomas
Section snippets
Hodgkin's disease
The incidence of Hodgkin's disease (HD) is about 4 per 100,000 persons per year, and accounts for less than 1% of all cancers worldwide. New cases of HD in the United States were estimated at 7880 and accounted for 14% of lymphomas [1], [2], [3]. HD has a bimodal incidence curve and occurs more frequently in two separate age groups, the first being young adulthood, the second being in those over 50 years old. About one third of people with HD have systemic symptoms, such as low-grade fever,
Staging
Accurate staging allows minimization of toxic therapies (such as extended field radiation or overly aggressive chemotherapy), thereby decreasing the risk of secondary malignancies, which exceeds 10% in historical series of patients with early-stage HD [40]. Ann Arbor staging is the staging system for lymphoma, both in HD and NHL. It initially was developed for HD, but it has some use in NHL [4].
The staging classification was modified after a 1988 meeting in Cotswold (UK) (Table 2) [41]. The
Assessment of treatment response
Tumor measurements on an axial cross-sectional imaging modality should be made as biperpendicular measurements in the axial plane (ie, the longest axial diameter by the largest perpendicular diameter). Diffuse, ill-defined lesions such as perirenal infiltration in NHL or pulmonary lymphatic spread are not measurable, but should be described [56].
Standardized guidelines for response assessment are important to facilitate interpretation of data and for comparison of the results among various
Summary
This article reviewed the clinical features of HD and NHL, common imaging features, the staging of lymphoma, and the role of FDG-PET in the assessment of patients with lymphoma. The significant changes that have occurred in the diagnosis and management of lymphoma over the past 20 years were emphasized.
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