Role of CT in the study of recurrences of Hodgkin's disease on the chest wall. Report on 12 cases.

ABSTRACT

Twelve cases of recurrences of Hodgkin's disease on the chest wall, associated with three breast lesions and three diaphragmatic lesions, were studied by computed tomography (CT). Although the chest radiographs of all the patients were abnormal, CT was more accurate than clinical and other radiological examinations in delineating the lesions of the chest wall and in studying the extension of the relapse. Muscle enlargement was present in all cases. In seven cases osseous lesions and in seven cases pleural effusion or subpleural plaques were found. Chest wall recurrences were associated with other thoracic or abdominal lesions in 75% of the cases. Recurrences to the chest wall occur late (mean 6.3 years) in the evolution of Hodgkin's disease. They developed during the first relapse in 67% of the cases and during the second to the fourth relapse in 33% of the cases. CT is useful for the screening of lesions for which the outcome is bad. Only in four cases patients were without any evidence of disease after treatment.