Chest radiography and computed tomography in the evaluation of mediastinal adenopathy in lymphoma.

Thoracic computed tomography (CT) in 232 patients with either primary staging of new or suggested relapsing lymphoma was compared with conventional chest radiography and both were correlated with clinical staging. Particular attention was given to the possibility of reducing routine thoracic CT, which is the current method used in this hospital in all patients with suggested lymphoma. Mediastinal lymphoma was detected by CT in 95 per cent of patients with clinically active mediastinal lymphoma, and by conventional chest radiography in 56 per cent. CT was found to be less reliable in evaluation of the hilar region than in that of other mediastinal areas. No areas of particular difficulty were found with chest radiography. CT also provided additional information concerning extra-mediastinal lymph adenopathy and involvement of the thoracic wall and pericardium. Routine thoracic CT examination was considered justifiable in all patients with suggested lymphoma.