AIDS-RELATED NON-HODGKINS-LYMPHOMA - ABDOMINAL CT FINDINGS IN 112 PATIENTS

OBJECTIVE. Non-Hodgkin's lymphoma is a common complication in patients with HIV infection. The purpose of this study was to analyze the abdo minal CT findings in a large series of patients with this condition. M ATERIALS AND METHODS. We retrospectively reviewed the abdominal CT exa minations of 110 men and two women (21-62 years old; average, 39 years ) with untreated AIDS-related lymphoma, as defined by the Centers for Disease Control. Lymphoma was the initial AIDS-defining illness in 79% of the patients. RESULTS. Abdominal CT scans showed normal findings o r only mild enlargement of the liver or spleen in 36% of the 112 patie nts, whereas evidence of intraabdominal lymphoma was seen in 64%. Evid ence of focal lymphomatous involvement was seen on abdominal CT scans in 58 (98%) of 59 patients in whom the predominant signs and symptoms were related to the abdomen and in 14 (26%) of 53 patients with extraa bdominal signs or symptoms. In the 64% of patients with evidence of in traabdominal lymphoma, lymph node enlargement was seen in 56% and extr anodal disease was seen in 86%. Extranodal sites of involvement in the 72 patients with evidence of intraabdominal lymphoma included the gas trointestinal tract (54%), liver (29%), kidney (11%), adrenal gland (1 1%), lower genitourinary tract (10%), spleen (7%), peritoneum and omen tum (7%), pancreas (5%), epidural space (4%), bone (3%), and muscle (1 %). Mild enlargement of the liver or spleen was present in a minority of cases. Moderate or marked hepatomegaly (cephalocaudal span > 20 cm) and splenomegaly (cephalocaudal span > 15 cm) were even less common a nd occurred only in the presence of focal hepatic lesions. CONCLUSION. Our results show that AIDS-related lymphoma may affect any abdominal organ, most commonly lymph nodes, the gastrointestinal tract, liver, k idney, and adrenal gland. Hepatic or splenic enlargement was uncommon and was not often seen as an isolated finding in the absence of eviden ce of abdominal lymphoma.