The role of the gallium scan in primary extranodal lymphoma.

UNLABELLED The purpose of this study was to examine the factors influencing gallium scan positivity for patients with primary extranodal lymphoma and to examine the role of the gallium scan in staging the disease and assessing response to initial treatment. METHODS Ninety-two patients with extranodal lymphoma who had a gallium scan were reviewed. The influences of tumor site, size, grade and the presence of clinically detectable disease after biopsy on the rate of gallium scan positivity were analyzed. The role of the gallium scan in staging and selecting treatment was assessed. Nineteen patients had a gallium scan to assess their response to treatment, and its predictive value was reviewed. RESULTS The overall gallium scan positivity (sensitivity) rate was 70%. This rate was low in patients whose extranodal lymphoma occurred in skin, intestine and testis, or was low grade (0%-25%). When these patients were excluded, the rate rose to 88%. Gallium scan positivity was not related to the presence of clinically detectable disease after biopsy and there was insufficient data about tumor size to determine a relationship. The gallium scan increased the disease stage in six patients (7%) and changed the initial treatment in six patients (7%). The gallium scan became negative in 15 (79%) of those patients who had a gallium scan to assess their response to treatment. All but two of these patients remain alive with a median follow-up of 3.75 yr. CONCLUSION The gallium scan was rarely positive for patients with skin, intestinal, testicular and low-grade lymphomas, but was otherwise comparable to lymphoma arising in lymph nodes. The result affected staging or treatment in seven patients (8%). After treatment, an initially-positive gallium scan usually became negative, a conversion associated with a favorable outcome.

[1]  S. Ben-Haim,et al.  Utility of gallium-67 scintigraphy in low-grade non-Hodgkin's lymphoma. , 1996, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[2]  E. K. J. Pauwels,et al.  Role of 67Ga scintigraphy in localization of lymphoma , 1996, Annals of Hematology.

[3]  D. Podoloff,et al.  Comparison of Nuclear Bone and Gallium Scans in the Therapeutic Evaluation of Bone Lymphoma , 1995, Clinical nuclear medicine.

[4]  S. Ben-Haim,et al.  Liver involvement in lymphoma: role of gallium-67 scintigraphy. , 1995, Journal of nuclear medicine : official publication, Society of Nuclear Medicine.

[5]  S. Ben-Haim,et al.  Gallium-67 scintigraphy in lymphoma with bone involvement. , 1995, Journal of nuclear medicine : official publication, Society of Nuclear Medicine.

[6]  M. Siegel,et al.  Ga‐67 Uptake in Cutaneous B‐Cell Lymphoma , 1994, Clinical nuclear medicine.

[7]  J. Boyages,et al.  The role of high dose 67-gallium scintigraphy in staging untreated patients with lymphoma. , 1994, Australian and New Zealand journal of medicine.

[8]  D. Rosenthal,et al.  Lymphoma: evaluation with Ga-67 SPECT. , 1987, Radiology.

[9]  M. Kondo,et al.  Value of gallium scans and lymphangiography in non‐Hodgkin's lymphoma of the Waldeyer's ring , 1986, Cancer.

[10]  G. Canellos,et al.  High-dose gallium imaging in lymphoma. , 1983, The American journal of medicine.

[11]  M Tubiana,et al.  Report of the Committee on Hodgkin's Disease Staging Classification. , 1971, Cancer research.

[12]  R. Taub,et al.  Comparison of gallium-67-citrate and thallium-201 scintigraphy in peripheral and intrathoracic lymphoma. , 1996, Journal of nuclear medicine : official publication, Society of Nuclear Medicine.