Purpose or Case Report: Current guidelines for initial cross-sectional imaging in pediatric lymphomas involves CT (Computed Tomography) of the chest, abdomen, and pelvis, ensuring that the radiation dose is As Low As Reasonably Achievable (ALARA). Whole-body MRI is favored over CT in this regard for diagnosing and staging the disease given its additional advantage of maximizing contrast resolution. Imaging characteristics of lymphoid tissue on MRI includes high T2 and STIR signal. Low and intermediate signal of lymphadenopathy on T2 and STIR is an unexpected finding noted anecdotally in nodular sclerosing Hodgkin’s lymphoma. These signal characteristics may be characteristic of histological subtype of the disease and may in future be used to avoid a biopsy diagnosis. In this study we aimed to review signal characteristics of lymphadenopathy in biopsy-confirmed nodular sclerosing Hodgkin’s lymphoma.
Methods & Materials: Retrospective review of available MR scans of patients with nodular sclerosing Hodgkin’s lymphoma was performed and an experienced pediatric radiologist reviewed the different MRI sequences regarding lymph node signal, especially on T2 and STIR.
Results: We reviewed MR imaging of 11 children with biopsy proven nodular sclerosing Hodgkin’s lymphoma. Mean age at the time of MRI was 14.8 (SD: 2.8) years and 9 were boys. Out of 11, 5 showed lymphadenopathy with T2/STIR low signal and 6 with T2/STIR intermediate signal. Central Gadolinium non-enhancement was observed in 4 patients.
Conclusions: All 11 patients (100%) with a diagnosis of nodular sclerosing Hodgkin’s lymphoma showed some lymphadenopathy that was not of high signal, and 5 children (45%) show frank low signal of some lymphadenopathy, a feature which may prove to be a biomarker for this histology.