Foust Alexandra,  Voss Stephan

Final Pr. ID: Poster #: CR-030

PET/CT plays an important role in assessing response to therapy in patients undergoing treatment for Hodgkin’s lymphoma (HL). A negative PET/CT following completion of chemotherapy has a high negative predictive value (>95%) for disease progression, relapse, or recurrence. Thus treatment decisions, including the decision to pursue radiation therapy or to alter chemotherapy regimens, are often made based on PET/CT results. Given the treatment implications, obtaining accurate PET/CT results is of the utmost importance. Read More

Authors:  Foust Alexandra , Voss Stephan

Keywords:  Abnormal FDG uptake in white fat, gluconeogenesis, Hodgkin lymphoma therapy implications

Arenos-abril Jesus,  Gonzalo Marta,  Coblenzt Ailish

Final Pr. ID: Poster #: EDU-006

Lymphoma is the third most frequent pediatric cancer after leukemia and brain tumors and can involve different organs with multiple imaging presentations and characteristics. Given that, pediatric radiologists must be familiar with the different imaging patterns that this disease represents in order to come up with the proper diagnosis at every moment. However, sometimes lymphoma imaging presentation can be challenging and simulate other diseases (historically called the great mimicker), which can mislead us to make a wrong diagnosis with consequent inappropriate or delayed treatment. On account of that, we have selected several cases throughout different years presenting at two institutions with imaging presentations resembling pediatric lymphoma, some of them resulting in true lymphoproliferative processes and others turning out to be simulating pathologies. We display the different cases on this educational poster and show what are the clues (if present) to properly distinguish between lymphomatous and simulating diseases from the imaging point of view and always with clinical correlation. In summary, the main purpose of this poster is to represent the imaging differences between pediatric lymphoma and its possible mimickers through the presentation of different teaching cases and to highlight the clues that can help pediatric radiologists to distinguish adequately the different diseases. Read More

Authors:  Arenos-abril Jesus , Gonzalo Marta , Coblenzt Ailish

Keywords:  Lymphoma, Oncology

Alam Aisha,  Maier Pia,  Smitthimedhin Anilawan,  Acord Michael,  Cahill Anne Marie,  Vatsky Seth

Final Pr. ID: Paper #: 072

Lymphoma is the most common mediastinal mass in children. Obtaining tissue for diagnosis can be challenging due to reported low diagnostic yield and risk of cardiorespiratory collapse, especially in the setting of anesthesia. We report our experience with biopsy of mediastinal masses, report the diagnostic rate for lymphoma and biopsy/anesthetic complications related to the procedure. Read More

Authors:  Alam Aisha , Maier Pia , Smitthimedhin Anilawan , Acord Michael , Cahill Anne Marie , Vatsky Seth

Keywords:  Image guided biopsy, Mediastinal Mass, Lymphoma

Baud Catherine,  Saguintaah Magali,  Bolivar Perrin Julie,  David Stephanie,  Couture Alain,  Prodhomme Olivier

Final Pr. ID: Poster #: EDU-015

1. To describe intussusception US aspect
2. To diagnose the different anatomic forms
3. To detect a leadpoint at the intussusceptum apex
4. To provide sonographic prognostic criteria
5. To recognize benign small bowel intussusception
6. To desmontrate US impact in the therapeutic management Read More

Authors:  Baud Catherine , Saguintaah Magali , Bolivar Perrin Julie , David Stephanie , Couture Alain , Prodhomme Olivier

Keywords:  Intussusception, Ischemia, Lymphoid hyperplasia, Burkitt lymphoma, Meckel diverticulum

Sato T Shawn,  Bajaj Manish,  Ferguson Polly

Final Pr. ID: Poster #: EDU-085

Chronic Recurrent Multifocal Osteomyelitis (CRMO) is a multifocal auto-inflammatory disease that has gained increased recognition in recent years. Because CRMO is a diagnosis of exclusion, clinical history and imaging findings are important in suggesting a diagnosis. While imaging features of CRMO have been described, other disease processes can have a similar appearance to CRMO. We review some diseases that can mimic the radiographic appearance of CRMO and discuss features that can suggest alternative diagnoses. Read More

Authors:  Sato T Shawn , Bajaj Manish , Ferguson Polly

Keywords:  CRMO, MRI, Lymphoma

Leake James,  Pfeifer Cory

Final Pr. ID: Poster #: EDU-089

Lymphoma (including both Hodgkin’s and non-Hodgkin’s) is the third most common pediatric malignancy. Treatment requires distinct definitions of bulky disease, response to therapy, and organ involvement. In this way, pediatric radiologists form a center role in the medical care of affected children. This educational exhibit examines pediatric lymphoma diagnosis and response to therapy by detailing the varying classification systems, including the newer PET-related Deauville and Lugano classification systems.

The Ann Arbor staging classification system for Hodgkin’s lymphoma was initially developed in the 1970’s and anatomically classifies lymphoma by site and number of lymph nodes affected, cross-diaphragmatic disease, and extralymphatic organ dissemination. More recently, after the introduction of PET/CT, newer classification systems which incorporated tumor metabolism were developed - including Deauville and Lugano. Notably, these systems are commonly applied to both Hodgkin’s and non-Hodgkin’s lymphoma. This educational exhibit includes a discussion of these various systems as well as annotated examples. Additionally, risk stratification is discussed using strata defined by the Children’s Oncology Group (COG), EuroNet, and Pediatric Hodgkin Consortium.

After review, the pediatric radiologist should feel more comfortable staging and classifying response to treatment of lymphoma using PET assessment principles. Read More

Authors:  Leake James , Pfeifer Cory

Keywords:  lymphoma, PET, lugano

Teo Yi-ming

Final Pr. ID: Poster #: CR-006

Intestinal lymphangiectasia is a rare disease characterised by dilated intestinal lacteals causing loss of lymph into the small bowel lumen and resultant hypoproteinemia, hypogammaglobulinemia, hypoalbuminemia and lymphopenia. The disease may occur as a primary / congenital form (primary idiopathic intestinal lymphangectasia / Waldmann disease) or as a secondary form resulting from causes of lymphatic obstruction, such as tumor or fibrosis.

Our case report describes the workup of an adolescent girl with known Primary Intestinal Lymphangiectasia (Waldmann disease) presenting with an acute history of abdominal pain and vomiting. We present her prior imaging leading to her initial diagnosis of Waldmann disease, as well as at the time of acute presentation, with imaging features raising suspicion for, and eventually leading to histo-pathologic confirmation of small bowel B-cell lymphoma.

Via this case report poster, we hope to create awareness of this rare disease, as well as its feared association of lymphoma. Typical imaging features are presented and discussed.
Read More

Authors:  Teo Yi-ming

Keywords:  Intestinal Lymphangiectasia, Lymphoma, Waldmann Disease

Venkatakrishna Shyam Sunder,  Rigsby Devyn,  Amiruddin Raisa,  Schoeman Sean,  Jalloul Mohammad,  Andronikou Savvas

Final Pr. ID: Poster #: SCI-032

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. Read More

Authors:  Venkatakrishna Shyam Sunder , Rigsby Devyn , Amiruddin Raisa , Schoeman Sean , Jalloul Mohammad , Andronikou Savvas

Keywords:  MRI, Nodular Sclerosing Hodgkin Lymphoma