Lymphographic Accuracy in Hodgkin??s Disease and Malignant Lymphoma with a Note on the "Reactive" Lymph Node as a Cause of Most False-Positive Lymphograms

Abstract

A prospective study of lymphographic accuracy in consecutive, previously untreated patients with Hodgkin's disease and non-Hodgkin's lymphoma was performed. Meticulous lymphographic-histologic correlation with material obtained at staging laparotomy revealed an overall accuracy of greater than 90% in the 240 patients suitable for analysis. The lymphogram interpreted as being negative for tumor was highly accurate (98%). The majority of lymphographic errors occurred as “false-positive” diagnosis; however, in most (16/18) of these cases, these lymphographically abnormal appearing lymph nodes were the result of pronounced non-specific “reactive” changes (fibrosis, sinus histiocytosis, reactive follicular hyperplasia, amorphous hyaline deposition, vascular transformation) which distorted the internal nodal architecture.