The current status of splenic computed tomography in patients with lymphoma

A major advance in the care of patients with Hodgkin's lymphoma would be a noninvasive technique for documenting splenic involvement. Currently, splenectomy is frequently required for accurately staging Hodgkin's disease within the abdomen. Splenic size alone is not a highly reliable sign of lymphomatous involvement. Normal-sized spleens may contain foci of tumour, and, in Hodgkin's disease, moderately enlarged spleens may be tumor-free. Computed tomography (CT) has proved reasonably reliable in distinguishing normal weight spleens from significantly enlarged ones. The splenic foci of lymphoma, however, have been difficult to detect by CT. When visualized, these are seen as low-CT number lesions within the splenic parenchyma. The success of bolus-injected, water-soluble contrast media in the detection of splenic lymphoma has been variable. In some cases visualization of the tumor foci was improved; in others, the lesions became isodense prior to scanning. In general, the use of water-soluble contrast media and conventional nondynamic CT equipment has not had a significant impact on detecting splenic involvement by lymphoma. (Auth.)