Abstract
Detecting extranodal disease in paediatric Hodgkin lymphoma is of great importance for both treatment and prognosis. Different imaging techniques can be used to identify these extranodal sites. This pictorial essay provides an overview of imaging features of extranodal disease manifestation in paediatric Hodgkin lymphoma.
Highlights
Childhood Hodgkin lymphoma is one of the most curable paediatric cancers, with long-term survival rates above 90% for early stage disease [1]
Both wholebody magnetic resonance imaging (MRI) and FDG-positron emission tomography (PET)/MRI have been investigated as alternatives to FDG-PET/computed tomography (CT) for staging Hodgkin lymphoma, in order to reduce radiation dose to the patient [7,8,9,10,11]
The European guidelines for imaging in paediatric Hodgkin lymphoma state that splenic involvement should be assumed if FDG-PET/CT positive lesions are confirmed by CT, MRI or US or if multiple small focal changes in the spleen structure are detected and suspicious for tumour, irrespective of the FDGPET/CT result [2]
Summary
Childhood Hodgkin lymphoma is one of the most curable paediatric cancers, with long-term survival rates above 90% for early stage disease [1]. CT computed tomography, FDG-PET 18F-fluoro-2-deoxy-D-glucose positron emission tomography, MRI magnetic resonance imaging, N/A not applicable an adult Hodgkin lymphoma study, whole-body MRI and FDG-PET/MRI were recently shown to have as comparable a diagnostic value as FDG-PET/CT for detecting bone marrow involvement [10, 17, 20, 21]. The current European guidelines for paediatric Hodgkin lymphoma state that focal FDG-PET positive lesions should be confirmed by contrast-enhanced CT, MRI or US to diagnose hepatic lymphoma involvement [2]. The European guidelines for imaging in paediatric Hodgkin lymphoma state that splenic involvement should be assumed if FDG-PET/CT positive lesions are confirmed by CT, MRI or US or if multiple small focal changes in the spleen structure are detected and suspicious for tumour, irrespective of the FDGPET/CT result [2].
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