Staging of patients with Hodgkin's disease: what should be done?

An overview of the place and use of diagnostic investigations necessary for staging of patients with Hodgkin's disease is given. Staging followed by specific treatment according to stage remains the corner stone in the management. New imaging techniques such as computed tomography and ultrasound cannot completely replace lymphangiography. Staging laparotomy should not be used routinely in clinical stage I and II patients. In the past, staging laparotomy was performed to identify those patients for whom management decisions would depend on the identification of abdominal disease. However, with the identification of prognostic factors and the subsequently selected therapy-regimens including treatment of possible spleen involvement, the role of laparotomy in patients management has largely decreased.