Hodgkin lymphoma: hypodense lesions in mediastinal masses

• Published in: Scientific reports Vol. 14; no. 1; pp. 14591 - 9
• Main Authors: Damek, Adrian, Kurch, Lars, Franke, Friedrich Christian, Attarbaschi, Andishe, Beishuizen, Auke, Cepelova, Michaela, Ceppi, Francesco, Daw, Stephen, Dieckmann, Karin, Fernández-Teijeiro, Ana, Feuchtinger, Tobias, Flerlage, Jamie E., Fosså, Alexander, Georgi, Thomas W., Hasenclever, Dirk, Hraskova, Andrea, Karlen, Jonas, Klekawka, Tomasz, Kluge, Regine, Körholz, Dieter, Landman-Parker, Judith, Leblanc, Thierry, Mauz-Körholz, Christine, Metzler, Markus, Pears, Jane, Steglich, Jonas, Uyttebroeck, Anne, Vordermark, Dirk, Wallace, William Hamish, Wohlgemuth, Walter Alexander, Stoevesandt, Dietrich
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 25.06.2024; Nature Publishing Group; Nature Portfolio
• Subjects: 631/67; 631/67/2321; 692/308/409; Adolescent; Adult; Aged; Computed tomography; Female; Fluorodeoxyglucose F18; Hodgkin Disease - diagnostic imaging; Hodgkin Disease - pathology; Hodgkin lymphoma; Hodgkin's lymphoma; Humanities and Social Sciences; Humans; Hypodense lesion; Lesions; Lymphoma; Male; Mediastinal Neoplasms - diagnostic imaging; Mediastinal Neoplasms - pathology; Mediastinum - diagnostic imaging; Mediastinum - pathology; Middle Aged; multidisciplinary; Positron emission tomography; Progression-Free Survival; Risk groups; Science; Science (multidisciplinary); Thymic cyst; Tomography; Tomography, X-Ray Computed; X-ray computed; Young Adult; Tomography; Hypodense lesion; Thymic cyst; X-ray computed; Hodgkin lymphoma
• ISSN: 2045-2322; 2045-2322
• DOI: 10.1038/s41598-024-64253-8

Hypodense volumes (HDV) in mediastinal masses can be visualized in a computed tomography scan in Hodgkin lymphoma. We analyzed staging CT scans of 1178 patients with mediastinal involvement from the EuroNet-PHL-C1 trial and explored correlations of HDV with patient characteristics, mediastinal tumor volume and progression-free survival. HDV occurred in 350 of 1178 patients (29.7%), typically in larger mediastinal volumes. There were different patterns in appearance with single lesions found in 243 patients (69.4%), multiple lesions in 107 patients (30.6%). Well delineated lesions were found in 248 cases (70.1%), diffuse lesions were seen in 102 cases (29.1%). Clinically, B symptoms occurred more often in patients with HDV (47.7% compared to 35.0% without HDV (p = 0.039)) and patients with HDV tended to be in higher risk groups. Inadequate overall early- 18 F-FDG-PET-response was strongly correlated with the occurrence of hypodense lesions (p < 0.001). Patients with total HDV > 40 ml (n = 80) had a 5 year PFS of 79.6% compared to 89.7% (p = 0.01) in patients with HDV < 40 ml or no HDV. This difference in PFS is not caused by treatment group alone. HDV is a common phenomenon in HL with mediastinal involvement.