Roentgenologic aspects of Hodgkin's disease.II. Role of Routine Radiographs in Detecting Initial Relapse

The role of routine follow-up diagnostic radiographs in detecting initial relapse in Hodgkin's disease was assessed. Of 442 patients treated for cure between 1955-1970, 130 suffered relapse. Significantly, the diagnosis of relapse was initiated by radiographic findings alone (patients who were symptomatically and clinically without evidence of disease) in 35% of all relapses. These findings were equally divided between changes in retroperitoneal lymph nodes and in the mediastinum/lungs, and emphasize the value of routine surveillance abdominal and chest films, as well as repeat lymphangiography in selected cases. In 30% of all relapses, detection was based upon combined radiographic and clinical findings, while the remaining 35% were initiated primarily on the basis of clinical findings. There were 77 radiographically detected anatomic sites of relapse: 44 were seen on the abdominal film (34 abnormal retroperitoneal lymph nodes, 6 bone lesions, 4 enlarged spleens) and 31 on the chest radiographs (12 parenchymal lesions, 11 mediastinal and/or hilar adenopathies, 5 pleural effusions, and 3 bone lesions). Two sites were in the skull.