LYMPHOMA THE MANAGEMENT OF NON-HODGKIN'S

"Gallium scans were performed as part of the initial evaluation in 45 patients with non-Hodgkin's lymphoma. Eighteen of these patients underwent staging laparotomy and splentctomy. In addition, scans were performed either shortly after therapy was completed or during subsequent followup in 10 patients. The initial scans were found most useful for patients with histiocytic lymphoma: in detecting sites of involvement above the diaphragm and the high para-aortic/mesenteric region, and when tumors were greater than 2 cm in diameter. The addition of "Ga scanning to the pre-operative clinical evaluation reduced the number of incorrectly staged patients from 8 to 4. Reversion of previously positive "Ga scans to negative in 3 patients with suspected persistent or recurrent disease was associated with fibrosis and no lymphoma when biopsied. Five other patients had histologically documented positive 87Ga scans post-therapy; in 1 the "Ga scan was only definitive noninvasive procedure. Despite the occurrence of both false-positive and false-negative "Ga scans, this procedure appears to be a useful supplement to the pretreatment evaluation of patients with non-Hodgkin's lymphoma, especially the histiocytic form. Confirmation of its ability to detect high para-aortic/mesentric involvement may subsequently result in a reduction of the number of staging laparotomies necessary. For the post-treatment followup of these patients '?Ga scans may prove to be a valuable noninvasive investigation. CUWU 36:1690-1741, 1975. CCURATE DOCUMENTATION OF THE EXA tent of disease is of major importance when considering appropriate management for patients with malignant lymphoma and other neoplasms. The use of various radiologic procedures, e.g. lymphangiograms, and radioisotopic scans of different organs, e.g. liver, spleen, and bone, has assisted in this evaluation. However, all of these techniques suffer from some degree of inaccuracy, and it has been frequently necessary to resort to surgical procedures for more definitive doc~mentation.'~ Initial studies by Edwards and Hayes demon