Splenic involvement in lymphomas - Evaluation on serial CT examinations

Purpose: To prospectively evaluate changes in splenic volume (SV) on serial CT of patients with lymphoma and correlate them with other indicators of t he disease process. Material and Methods: SV was calculated in 290 abdominal CT examinations of 58 consecutive adults with lymphoma (42 non-Hodgkin's lymphoma, 16 Hodgkin 's disease). Each patient had one CT investigation before, 2 during chemoth erapy and 2 post-chemotherapy. The changes in SV were correlated with clini cal, laboratory and other imaging indicators of the disease process. Results: Three groups of patients were identified. Group A (n = 20) present ed no changes in SV showed no splenic parenchymal abnormalities and had nor mal Str and serum lactic dehydrogenase (S-LDH). Group B (n = 25) presented a decrease in SV during treatment suggesting response to therapy. Splenic p arenchymal abnormalities (n = 5) and other subdiaphragmatic sites of involv ement (n = 20) underwent remission during treatment. Eighteen patients with high S-LDH at presentation showed normal values during therapy. Group C (n = 12) showed an increase in SV post-therapy associated with manifestations of disease recurrence. The S-LDH levels were elevated in 10 patients at th e same time. Conclusion: Quantitatively assessed splenic size on CT may serve as an indi cator of splenic involvement in the course of lymphomas.