Bragg D G
Department of Radiology, University of Utah School of Medicine, Salt Lake City.
Curr Probl Diagn Radiol. 1987 Jul-Aug;16(4):177-206. doi: 10.1016/s0363-0188(87)80001-4.
Lymphomas are a group of diseases that provide the radiologist and clinician with unusual challenges. In most cases, an understanding of the histologic classification and staging is essential to design the imaging workup for the patient. Precise staging is critical, particularly for patients with HD and extranodal NHL. The malignant lymphomas share many similar radiographic features, yet have notable differences. An understanding of the pattern of extension of HD is useful in choosing an imaging modality for both staging and follow-up. Contiguous extension of HD follows lymphatic channels and is primarily limited to nodal compartments in the mediastinum and retroperitoneal lymph nodes. On the other hand, NHL may be either widespread or extranodal and localized. In the first instance, the histology will be low grade; in the second, intermediate or high grade. An understanding of these histologic clues is critical to the structuring of an efficient staging workup for the patient with NHL. Posttreatment follow-up imaging strategies should be governed by the fact that in both HD and NHL, recurrences are usually apparent within two years following initial treatment. Treatment complications must be separated from the manifestations of recurrent disease, a particularly important consideration in following up the patient with HD.
淋巴瘤是一类给放射科医生和临床医生带来特殊挑战的疾病。在大多数情况下，了解组织学分类和分期对于为患者设计影像学检查至关重要。精确分期至关重要，尤其是对于霍奇金淋巴瘤（HD）和结外非霍奇金淋巴瘤（NHL）患者。恶性淋巴瘤有许多相似的影像学特征，但也有显著差异。了解HD的扩散模式有助于选择用于分期和随访的影像学检查方法。HD的连续性扩散沿淋巴管进行，主要局限于纵隔和腹膜后淋巴结的结区。另一方面，NHL可能广泛分布或局限于结外。在前一种情况下，组织学类型为低级别；在后一种情况下，为中级别或高级别。了解这些组织学线索对于为NHL患者构建有效的分期检查至关重要。治疗后的随访影像学策略应基于这样一个事实，即无论是HD还是NHL，复发通常在初始治疗后的两年内出现。必须将治疗并发症与复发性疾病的表现区分开来，这在随访HD患者时是一个特别重要的考虑因素。
