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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.