CONTRAST VISUALIZATION OF THE VENAE CAVAE IN MANAGEMENT OF LYMPHOMA

The most important factor in estimating the prognosis and choosing the treatment of histologically proved malignant lymphoma is the clinical extent of the disease.¹ This is determined by the symptom complex, physical findings, laboratory studies, and roentgenographic examinations.

A considerable number of patients are encountered in whom only localized evidence of disease is apparent by these studies. In many of these patients the disease is already disseminated. Thus, extensive silent intra-abdominal disease may be present with only satellite inguinal or femoral nodes being evident. The same relationship is often true of cervical and axillary nodes with intrathoracic disease. An apparently unicentric lymphoma may therefore be improperly staged as class 1 (according to classifications of Craver²) and receive intensive local therapy. This is particularly undesirable as the patient's reserve may be needlessly depleted while a potentially more serious site progresses unchecked. The moderately aggressive management of class 2 cases