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Radiologische Diagnostik von Hodgkin- und Non-Hodgkin-Lymphomen des Thorax

Radiological diagnosis of thoracic Hodgkin- and Non-Hodgkin lymphomas

  • Maligne Thoraxtumoren: CT und MRT
  • Published:
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Zusammenfassung

Lymphomerkrankungen gehören in den westlichen Ländern zu den bedeutenden Malignomen, insbesondere die Non-Hodgkin-Lymphome weisen eine steigende Inzidenz auf. Der Thorax ist der Ort der Primärmanifestation insbesondere beim Hodgkin-Lymphom, eine Progredienz der Erkrankung und therapieassoziierte Komplikationen entwickeln sich bei beiden Lymphomarten häufig intrathorakal. Bildmorphologisch lassen sich die verschiedenen Lymphome nicht unterscheiden, Aufschlüsse geben allerdings die Ausbreitungswege der Erkrankung. Ein primärer oder sekundärer Lungenbefall stellt die Radiologie vor eine differenzialdiagnostische Herausforderung, die Muster sind sowohl im Thoraxübersichtsbild als auch in der CT variabel und unterliegen einem Wandel unter der Therapie. Radiologische Verfahren, insbesondere die CT, sind integraler Bestandteil des Stagings bei Erstmanifestation und Verlaufskontrolle. Die MRT erleichtert die Beurteilung von Thoraxwandlymphomen. Die PET als funktionelles bildgebendes Verfahren hat einen festen Platz in der Diagnostik der hochmalignen Lymphome, die Kombination aus morphologischen und funktionellen Bildern in der PET-CT avanciert zum diagnostischen Standard der Zukunft.

Abstract

Malignant lymphomas belong to the most important malignant diseases in western countries with an increasing incidence of Non-Hodgkin lymphoma. The thorax is the location of primary manifestation especially in patients with Hodgkin’s disease. Progression of disease and therapy associated complications are frequently located in the chest.

Based on morphological imaging criteria the two types of lymphoma cannot be differentiated, helpful for differentiation is, however, the way of disease spread. Primary and secondary thoracic lymphoma represent a diagnostic challenge in radiology: the patterns are variable in radiography as well as in computed tomography and alter under therapy.

Radiological studies, especially CT, are an integral part of the staging process. MRI is considered advantageous for chest wall disease. PET as functional imaging technique has its proven role for staging of high grade lymphomas, the combination of functional and morphological information provided by PET-CT will become the first diagnostic standard in the future.

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  1. Universitätsklinik für Radiodiagnostik, Allgemeines Krankenhaus Wien

    M. Uffmann & C. Schaefer-Prokop

  2. Universitätsklinik für Radiodiagnostik, Allgemeines Krankenhaus, Währinger Gürtel 18–20, 1090 , Wien, Österreich

    M. Uffmann

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Uffmann, M., Schaefer-Prokop, C. Radiologische Diagnostik von Hodgkin- und Non-Hodgkin-Lymphomen des Thorax. Radiologe 44, 444–456 (2004). https://doi.org/10.1007/s00117-004-1059-z

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