Diagnostic Value of Multi Detector Computed Tomography in Evaluation of Abdominopelvic Extra-nodal Lymphoma with Assessment of Therapeutic Response

Background: Patients with lymphoproliferative diseases frequently develop non-Hodgkin lymphoma or Hodgkin disease outside of the lymph nodes, a condition known as extra-nodal lymphoma. Non-Hodgkin lymphomas and Hodgkin disease are best imaged anatomically using Multi Detector Computed Tomography (MDCT).
Aim and Objectives: To evaluate the possible MDCT imaging findings in patients with pelviabdominal extra-nodal lymphoma before and after therapy. Patients and methods: This quasi-experimental study involved 18 cases, whose ages ranged from 18 to 81 years (10 males and 8 females), with extra-nodal lymphoma of the abdominal and pelvic organs. The study was conducted at the Radiology Department, Suez Canal University, and Mansoura Oncology Hospital, with an assessment of therapy response by MDCT scan. Results: The spleen was found to have the highest number of diseases among the pelvic and solid organs, followed by the liver and the uterus. Regarding the GIT affection, in descending order, the stomach, intestine, and esophagus were affected. MDCT scan showed diffuse intestinal wall thickening with luminal dilation of intestinal loops. The majority of cases were found to be non-Hodgkin lymphoma (83.3%), with diffuse large B cell lymphoma being the most prevalent subtype (15 individuals). Hodgkin lymphoma was found in 3 patients (16.6%) with mixed cellularity. Conclusion: MDCT is the most preferred and widely used imaging modality to evaluate lymphomatous involvement in extra-nodal sites. It provides details about the nature and extension of the lesion. Also, it can be used to guide needle biopsy into a suspicious area.