Diagnosis of neoplastic alterations of the lymph nodes of the retroperitoneal space

For the diagnostic judgement of the retroperitoneal lymph nodes three methods are now at hand: ultrasonography, computerized tomography and lymphography. The study was aimed to analyse the diagnostic value of each method and to work out recommendations for thei diagnostic use. In 96 patients with Hodgkin's disease, non-Hodgkin lymphoma, non-testicular seminoma and seminoma one investigaiton each by ultrasonography, computerized tomography and lymphography was carried through to ascertain whether and to what extent the retroperitoneal lymph nodes are affected by the underlying pathological process. In 62 patients laparotomy respectively the histological findings led to a reference diagnosis. Accordng to the evaluation, sensitivity was determined for ultrasonography at 79.1%, for computerized tomography at 91,6% and for lymphography at 83.3%, and specificity was found to be for ultrasonography 94.7%, for computerized tomography 89.4% and for lymphography 94.7%. The two tomographic methods turned out to be advantageous in that not only the retroperitoneal space but also the abdominal area respectively the neighbouring organs can be judged. In principle it is also possible with lymphography to prove affections of lymph nodes which are not enlarged; yet this advantage was decisive for the diagnosis only in one of the patients examined. (orig.)