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Non-Hodgkin Lymphoma
Virginia Barnes Planz, MD; Hollins Clark, MD
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KEY FACTS

  • Imaging

    • Diagnostic Checklist

      TERMINOLOGY

      • Definitions

        • Non-Hodgkin lymphoma (NHL)
          • Broad category of T-cell and B-cell malignancies with diverse range of disease
          • Hematogenous spread of NHL is unpredictable in comparison to contiguous spread of HL
          • ~ 1/2 present with mixed nodal and extranodal disease and ~ 1/4 present with isolated extranodal disease
          • When disease is primarily nodal or mixed, extranodal involvement is usually seen at certain sites: Spleen, liver, kidney, lung, bone, and bone marrow
          • Isolated extranodal disease has different range of extranodal sites: GI tract, GU (including ovaries and testes), thyroid, bone, brain, liver, breast, skin, thymus, sinonasal, Waldeyer ring, and CNS

      IMAGING

      • F-18 FDG PET/CT Findings

        • F-18 FDG PET/MR Findings

          • CT & MR Findings

            DIFFERENTIAL DIAGNOSIS

              PATHOLOGY

              • General Features

                • Ann Arbor Staging System With Lugano Modification

                  • Classification

                    CLINICAL ISSUES

                    • Presentation

                      • Demographics

                        • Natural History & Prognosis

                          • Treatment

                            DIAGNOSTIC CHECKLIST

                            • Consider

                              • Image Interpretation Pearls

                                Selected References

                                1. Giraudo C et al: 18F-fluorodeoxyglucose positron emission tomography/magnetic resonance in lymphoma: comparison with 18F-fluorodeoxyglucose positron emission tomography/computed tomography and with the addition of magnetic resonance diffusion-weighted imaging. Invest Radiol. 51(3):163-9, 2016
                                2. Platzek I: (18)F-Fluorodeoxyglucose PET/MR Imaging in Lymphoma. PET Clin. 11(4):363-73, 2016
                                3. Barrington SF et al: Role of imaging in the staging and response assessment of lymphoma: consensus of the International Conference on Malignant Lymphomas Imaging Working Group. J Clin Oncol. 32(27):3048-58, 2014
                                4. Cheson BD et al: Recommendations for initial evaluation, staging, and response assessment of Hodgkin and non-Hodgkin lymphoma: the Lugano classification. J Clin Oncol. 32(27):3059-68, 2014
                                5. Platzek I et al: PET/MR for therapy response evaluation in malignant lymphoma: initial experience. MAGMA. 26(1):49-55, 2013
                                6. Paes FM et al: FDG PET/CT of extranodal involvement in non-Hodgkin lymphoma and Hodgkin disease. Radiographics. 30(1):269-91, 2010
                                7. Weiler-Sagie M et al: (18)F-FDG avidity in lymphoma readdressed: a study of 766 patients. J Nucl Med. 51(1):25-30, 2010
                                8. Schöder H et al: PET Imaging for Response Assessment in Lymphoma: Potential and Limitations. Radiol Clin North Am. 46(2):225-41, 2008
                                9. Jhanwar YS et al: The role of PET in lymphoma. J Nucl Med. 47(8):1326-34, 2006
                                10. Raanani P et al: Is CT scan still necessary for staging in Hodgkin and non-Hodgkin lymphoma patients in the PET/CT era? Ann Oncol. 17(1):117-22, 2006
                                11. SEER Stat Fact Sheets: Non-Hodgkin Lymphoma
                                Related Anatomy
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                                Related Differential Diagnoses
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                                References
                                Tables

                                Tables

                                KEY FACTS

                                • Imaging

                                  • Diagnostic Checklist

                                    TERMINOLOGY

                                    • Definitions

                                      • Non-Hodgkin lymphoma (NHL)
                                        • Broad category of T-cell and B-cell malignancies with diverse range of disease
                                        • Hematogenous spread of NHL is unpredictable in comparison to contiguous spread of HL
                                        • ~ 1/2 present with mixed nodal and extranodal disease and ~ 1/4 present with isolated extranodal disease
                                        • When disease is primarily nodal or mixed, extranodal involvement is usually seen at certain sites: Spleen, liver, kidney, lung, bone, and bone marrow
                                        • Isolated extranodal disease has different range of extranodal sites: GI tract, GU (including ovaries and testes), thyroid, bone, brain, liver, breast, skin, thymus, sinonasal, Waldeyer ring, and CNS

                                    IMAGING

                                    • F-18 FDG PET/CT Findings

                                      • F-18 FDG PET/MR Findings

                                        • CT & MR Findings

                                          DIFFERENTIAL DIAGNOSIS

                                            PATHOLOGY

                                            • General Features

                                              • Ann Arbor Staging System With Lugano Modification

                                                • Classification

                                                  CLINICAL ISSUES

                                                  • Presentation

                                                    • Demographics

                                                      • Natural History & Prognosis

                                                        • Treatment

                                                          DIAGNOSTIC CHECKLIST

                                                          • Consider

                                                            • Image Interpretation Pearls

                                                              Selected References

                                                              1. Giraudo C et al: 18F-fluorodeoxyglucose positron emission tomography/magnetic resonance in lymphoma: comparison with 18F-fluorodeoxyglucose positron emission tomography/computed tomography and with the addition of magnetic resonance diffusion-weighted imaging. Invest Radiol. 51(3):163-9, 2016
                                                              2. Platzek I: (18)F-Fluorodeoxyglucose PET/MR Imaging in Lymphoma. PET Clin. 11(4):363-73, 2016
                                                              3. Barrington SF et al: Role of imaging in the staging and response assessment of lymphoma: consensus of the International Conference on Malignant Lymphomas Imaging Working Group. J Clin Oncol. 32(27):3048-58, 2014
                                                              4. Cheson BD et al: Recommendations for initial evaluation, staging, and response assessment of Hodgkin and non-Hodgkin lymphoma: the Lugano classification. J Clin Oncol. 32(27):3059-68, 2014
                                                              5. Platzek I et al: PET/MR for therapy response evaluation in malignant lymphoma: initial experience. MAGMA. 26(1):49-55, 2013
                                                              6. Paes FM et al: FDG PET/CT of extranodal involvement in non-Hodgkin lymphoma and Hodgkin disease. Radiographics. 30(1):269-91, 2010
                                                              7. Weiler-Sagie M et al: (18)F-FDG avidity in lymphoma readdressed: a study of 766 patients. J Nucl Med. 51(1):25-30, 2010
                                                              8. Schöder H et al: PET Imaging for Response Assessment in Lymphoma: Potential and Limitations. Radiol Clin North Am. 46(2):225-41, 2008
                                                              9. Jhanwar YS et al: The role of PET in lymphoma. J Nucl Med. 47(8):1326-34, 2006
                                                              10. Raanani P et al: Is CT scan still necessary for staging in Hodgkin and non-Hodgkin lymphoma patients in the PET/CT era? Ann Oncol. 17(1):117-22, 2006
                                                              11. SEER Stat Fact Sheets: Non-Hodgkin Lymphoma