Staging laparotomy in non-Hodgkin's lymphoma.

In 57 patients with non-Hodgkin's lymphoma, a clinical, radiographic, scintigraphic and pathological correlative study showed the following results: (1) the inferior venacavagram, lymphangiogram and gallium-67 scan have a low sensitivity in detecting lymphoma: their accuracy is high when the findings are interpreted as abnormal (93%, 83% and 80% respectively), but low when they are interpreted as normal (47%, 67% and 58% respectively); (2) the clinical evaluation of spleen and liver is unreliable; (3) the incidence of lymphocytic lymphoma in the para-aortic-iliac nodes is high; (4) a pattern of involvement by contiguity and a predilection for the spleen were observed in lymphocytic lymphoma; (5) in lymphocytic lymphoma there is no liver involve without concomitant splenic involvement; (6) no definite pattern of spread could be seen in histiocytic lymphoma; (7) surgical staging changed the classification of the lymphoma in 56% of cases, 46% being reclassified to a more advanced stage; (8) surgical staging significantly improves the assessment of the stage of disease and therefore permits accurate treatment planning.