Radiographic features of recurrent intrathoracic Hodgkin's disease following radiation therapy.

Of 254 consecutive, surgically staged, IA-IIIB Hodgkin's disease patients treated at the Joint Center for Radiation Therapy between April 1969 and July 1976, 21 developed intrathoracic relapses. This study evaluated the radiographic features of relapse in these 21 patients. The superior mediastinum (nine patients) and the lung parenchyma (10) were the most frequent sites of involvement. In contrast to patients who initially had Hodgkin's disease, extranodal lung relapses were not associated with radiographically detectable relapses in the hilum or mediastinum. The appearance of the pulmonary relapses included both single and multiple nodules, with or without cavitation, and with both sharp and irregular margins. Due to this nonspecific appearance at relapse, tissue should be obtained in patients suspected of having recurrent Hodgkin's disease.