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Calcification in Lymphoma Occurring Before Therapy

CT Features and Clinical Correlation

¹ Department of Diagnostic Imaging, Chaim Sheba Medical Center, Tel Hashomer, Ramat Gan 52621, Israel.
² Department of Diagnostic Imaging, Sapir Medical Center, Kfar Saba 44281, Sackler School of Medicine, University of Tel Aviv, Tel Aviv 69978, Israel.
³ Institute of Hematology, Chaim Sheba Medical Center, Tel Hashomer, 52621 Israel.

OBJECTIVE. Calcification in lymphoma occurring before therapy is rare. We assessed the prevalence, CT features, and clinical significance of calcification in nodes and masses in patients with lymphoma occurring before therapy.

SUBJECTS AND METHODS. CT of the chest, abdomen, and pelvis of 956 newly diagnosed patients with lymphoma was evaluated prospectively for calcifications in enlarged lymph nodes and lymphoma masses. Findings were correlated with histologic type of disease, tissue parameters, and clinical course. Calcifications were further evaluated on follow-up CT.

RESULTS. Of 956 patients with lymphoma (704 with non-Hodgkin's lymphoma and 252 with Hodgkin's lymphoma), eight patients (0.84%) showed calcifications in involved sites, seven of whom had non-Hodgkin's lymphoma and one of whom had Hodgkin's lymphoma. Calcifications were present in lymph nodes and masses in the mediastinum in five patients, in the retroperitoneum in two patients, and in the adrenal in one patient. All eight patients had the aggressive type of lymphoma. Four patients later relapsed, one of whom died. A fifth patient died after only minimal response to treatment.

CONCLUSION. Calcification in patients with lymphoma occurring before therapy is rare as opposed to that in lymphoma after therapy. It occurred in our patients more often in the mediastinum, in patients with non-Hodgkin's lymphoma rather than in patients with Hodgkin's lymphoma, and only in patients with the aggressive type of disease.

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