Abstract
From January 1968 to March 1975, 115 patients with malignant lymphomas, all aged under 15 years, were admitted to the Istituto Nazionale Tumori of Milan: 57 had Hodgkin's disease (mean age 9.7 yrs) and 58 non-Hodgkin's lymphomas (mean age 7.7 yrs). In this group of consecutive unselected and untreated patients the incidence of lesions radio-logically evident at disease presentation was comparatively evaluated in relation to histology. 36 cases underwent a subsequent diagnostic laparotomy with splenectomy. Chest X-ray was performed in all patients. It proved to be pathologic in 44 % of patients with Hodgkin's disease (mediastinal adenopathies were present in all cases). Pulmonary lesions were documented in 5 %, pleural in 2 % and skeletal in 2 %. Lymphography showed retroperitoneal involvement in 16 % with Hodgkin's disease and in 29 % with malignant lymphomas; radiological findings were confirmed by laparotomy in 35/36 cases. Skeletal survey proved to be abnormal in only 2 % of Hodgkin's compared to 18 % of non-Hodgkin's lymphomas. All lesions were clinically symptomatic. Intestinal involvements (small bowel and colon), which were always symptomatic, were present in 15 patients with non-Hodgkin's lymphoma (26%). IVP showed direct involvement of kidneys in 2 patients with non-Hodgkin's lymphoma. The comparison of radiological findings in the two groups of patients confirm that non-Hodgkin's lymphomas have a more aggressive initial spread: 43 % of patients were classified as stage IV at disease presentation. At the same time, our data prove that some of these diagnostic tools are of scant use when performed as a screening procedure for occult lesions.
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