An observational study of abdominal organ involvement detected by ultrasound and computed tomography in children suffering from lymphoreticular malignancy at a tertiary care hospital in Eastern India

Abstract

Abstract Introduction: Abdominal organs are usually involved in lymphoreticular malignancies (LRM), and the detection is crucial for Initial staging, determination of the location and extent of disease, and is the hallmark for the choice of treatment. At present, the established radiological technique for staging Hodgkin's disease is computed tomography (CT) and ultrasonography (USG) in our country. Objective: The objective of the study was to evaluate the pattern of abdominal organ involvement in childhood LRM by USG and CT and to analyze the findings. Methods: The study included 121 children with newly diagnosed childhood LRM who underwent real time USG and contrast enhanced CT scan. The records of the US and CT scanning were analyzed with respect to size, shape, margins, echogenicity/density pattern of various abdominal organs and lymph nodes to evaluate the extent and pattern of abdominal organ involvement by the disease process. Results: Out of 121 cases of LRM, US detected significant portal lymphadenopathy in 9 (7.44%) cases where CT detected enlarged portal nodes in only 3 and missed in 6 cases. However in the retroperitoneal lynphadenopathy CT scored over US, as CT detected 16 (13.22%) cases as against 13 (10.74%) cases detected by US. Conclusion: In our study we observed abdominal organs are commonly involved at the time of initial presentation in childhood LRM, with diffuse organomegaly being commoner than focal lesions. Abdominal symptoms and GIT involvement were also found more common in NHL patients at their initial presentation. There are no characteristic patterns of involvement either on US or CT which are specific to any individual disease entity. Although organomegaly and focal lesions are not diagnostic, but in a known case of childhood LRM these are highly suggestive of involvement by the existing disease process. There is no significant difference in the detection rate of abdominal organ involvement by US and CT in our study. However US being safer and cheaper, US may be suggested as the primary imaging modality to detect abdominal organ involvement in childhood LRM at initial presentation.