What is the role of ultrasonography in thoracic non-Hodgkin lymphoma (NHL) imaging?

Updated: Mar 05, 2019
  • Author: Ali Nawaz Khan, MBBS, FRCS, FRCP, FRCR; Chief Editor: Eugene C Lin, MD  more...
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Although US has traditionally been used to differentiate solid from cystic masses elsewhere in the body, the study has been extended to evaluating the anterior mediastinum and to assist in determining a connection between a mass and adjacent structures. US is more useful than other studies in the evaluation of vascular abnormalities and of masses associated with the heart. In general, given the accuracy and detail provided by CT, MRI, and selected radionuclide scans, US techniques generally are not used as primary tools in the evaluation of mediastinal lymphadenopathy. [28, 29]

Although mediastinal US is rarely used in the United States to assess NHL, it might play a role in the diagnostic workup of mediastinal pathology as an adjunct technique to other imaging studies, such as conventional chest radiography, CT scanning, and MRI.

The pleural space lends itself well to ultrasonographic examination in the presence of pleural effusions. US can be used to evaluate the extent and characteristics of the effusions, as well as the presence or absence of pleural nodules and/or masses. US is an excellent tool when pleural intervention is planned.

NHL has a secondary cardiac localization in 20% of patients, but primary cardiac NHL is extremely rare, and only sporadic cases have been reported; most are diagnosed on autopsy. As a noninvasive technique, echocardiography may depict these tumors early, but the prognosis  nevertheless remains poor.

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