Hodgkin lymphoma: hypodense lesions in mediastinal masses.
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Damek Adrian, Kurch Lars, Franke Friedrich Christian, Attarbaschi Andishe, Beishuizen Auke, Cepelova Michaela, Ceppi Francesco, Daw Stephen, Dieckmann Karin, Fernández-Teijeiro Ana, Feuchtinger Tobias, Flerlage Jamie E, Fosså Alexander, Georgi Thomas W, Hasenclever Dirk, Hraskova Andrea, Karlen Jonas, Klekawka Tomasz, Kluge Regine, Körholz Dieter, Landman-Parker Judith, Leblanc Thierry, Mauz-Körholz Christine, Metzler Markus, Pears Jane, Steglich Jonas, Uyttebroeck Anne, Vordermark Dirk, Wallace William Hamish, Wohlgemuth Walter Alexander, Stoevesandt Dietrich
Аннотация
Hypodense volumes (HDV) in mediastinal masses can be visualized in a computed tomography scan in Hodgkin lymphoma. We analyzed staging CT scans of 1178 patients with mediastinal involvement from the EuroNet-PHL-C1 trial and explored correlations of HDV with patient characteristics, mediastinal tumor volume and progression-free survival. HDV occurred in 350 of 1178 patients (29.7%), typically in larger mediastinal volumes. There were different patterns in appearance with single lesions found in 243 patients (69.4%), multiple lesions in 107 patients (30.6%). Well delineated lesions were found in 248 cases (70.1%), diffuse lesions were seen in 102 cases (29.1%). Clinically, B symptoms occurred more often in patients with HDV (47.7% compared to 35.0% without HDV (p = 0.039)) and patients with HDV tended to be in higher risk groups. Inadequate overall early-18F-FDG-PET-response was strongly correlated with the occurrence of hypodense lesions (p < 0.001). Patients with total HDV > 40 ml (n = 80) had a 5 year PFS of 79.6% compared to 89.7% (p = 0.01) in patients with HDV < 40 ml or no HDV. This difference in PFS is not caused by treatment group alone. HDV is a common phenomenon in HL with mediastinal involvement.