Investigation of retroperitoneal lymph nodes in Hodgkin's disease.

For staging of Hodgkin's disease 45 patients underwent lymphography and abdominal computed tomography (CT); in 31 of them ultrasound examination was also performed. In cases of retroperitoneal lymph node enlargement lymphography and CT are diagnostically equivalent, whereas the poorer resolution of ultrasound reduces the reliability of this method when the lymph nodes are only slightly enlarged. Theoretically with lymphography also small lymphomatous lesions in normal-sized lymph nodes should be possible to demonstrate, but there is a clear tendency to overdiagnosis. CT is therefore recommended as the initial method and this examination is considered sufficient both in clearly negative and clearly positive cases. In doubtful cases and in those where CT has revealed solitary slightly enlarged lymph nodes, the examination should be supplemented with ultrasonic scanning and lymphography.