Correlation of Whole-Body Computed Tomography Staging With Histopathological Grade in Follicular Lymphoma

Abstract

PURPOSE. To correlate the computed tomography (CT) features and clinical stages between low- and high-grade follicular lymphoma (FL). MATERIALS AND METHODS. We screened 73 patients diagnosed with FL between 2006 and 2015 and enrolled 68 patients for final analysis. We reviewed the clinical parameters and CT features, including age, sex, the stages of lymphoma, involvement sites, and the pathological grades. Statistical analysis included Pearson's Chi-square test, Fisher's exact test, and independent t-test. RESULTS. Grade 1 and 2 FL group has preference in involving infradiaphragmatic regions (p = 0.001), such as para-aortic (p ＜ 0.001) and mesenteric (p ＜ 0.001) nodes and tends to involve more infradiaphragmatic sites (p = 0.003). Grade 3 FL group has a higher tendency of involving supradiaphragmatic lymph nodes (21 out of 27 patients, 77.8%) albeit not statistically significant. Grade 3A FL has more nodal regions involvement as compared with the Grade 3B FL (p = 0.003). CONCLUSIONS. Grade 1 and 2 FL cases usually involve infradiaphragmatic regions, particularly para-aortic and mesenteric nodes, whereas a higher percentage of Grade 3 FL cases involve supradiaphragmatic lymph nodes, but no statistically significant difference is observed. Grade 3B disease is considered a unique form of FL clinically and genetically. Grade 3A FL shares similar anatomical distribution with Grade 3B FL but shows more diffuse involvement.