Learning objectives
Review the epidemiology of lymphoma and associated risk factors to raise diagnostic suspicion as appropriate.
Identify imaging features of lymphoma in multiple organ systems and modalities.
Background
According to the American Cancer Society, lymphoma accounted for approximately 4.8 % of new cancer diagnoses in the United States in 2018 [1]. Lymphoma can present in nodal or extra-nodal tissue and is broadly classified into Hodgkin lymphoma (HL) or non-Hodgkin lymphoma (NHL), with additional subtypes based primarily on the cell type of origin. NHL makes up the majority of lymphoma cases, accounting for approximately 90% of all lymphoma cases in 2018 [1]. Clinical presentation can be nonspecific and include constitutional symptoms such as unexplained...
Imaging findings OR Procedure details
STAGING
Staging of lymphoma is based on the Lugano classification system [2, 23]:
Stage I:
One lymph node region or lymphoid organ (including the spleen and thymus)
E: only one part of one extranodal organ in the absence of lymph node involvement
Stage II:
Two or more lymph node areas on the same side above or below the diaphragm
E: one extranodal organ from limited contiguous regional lymph node involvement
Stage III:
Lymph node regions above and below the diaphragm
S: lymph nodes above the...
Conclusion
Lymphoma can be challenging to identify on imaging due to the variability of its appearance depending on the location in which it manifests. Prompt and accurate diagnosis is key for guiding therapy and subsequently patient outcomes. Therefore, it is important for Radiologists to be aware of the risk factors and imaging characteristics of lymphoma to raise diagnostic suspicion for lymphoma when appropriate.
References
1.American Cancer Society. Cancer Facts & Figures 2018. Atlanta, GA: American Cancer Society; [updated June 2018; cited April 2019]. Available from: https://www.cancer.org/content/dam/cancer-org/research/cancer-facts-and-statistics/annual-cancer-facts-and-figures/2018/cancer-facts-and-figures-2018.pdf
2.American Cancer Society. Hodgkin Lymphoma Stages. Atlanta, GA: American Cancer Society; [updated May 1 2018; cited August 2019]. Available from: https://www.cancer.org/cancer/hodgkin-lymphoma/detection-diagnosis-staging/staging.html
3.Ganeshalingam S, Koh DM. Nodal staging. Cancer Imaging. 2009; 9(1):104–111. Published 2009 Dec 24. doi:10.1102/1470-7330.2009.0017
4.Johnson SA, Kumar A, Matasar MJ, et al. Imaging for Staging and Response Assessment in Lymphoma. RadioGraphics. Jul 2015, 276:2, 323-338.
5.Lukas RV, Stupp R, Gondi V,...