الفهرس 
Aim of The WorkOnly 14 pages are availabe for public view
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Abstract
Lymphoma is a group of oncological diseases characterized by a malignancy developing from lymphoid tissue. It is a group of distinct entities with widely varying clinical features, histology, immune-phenotypes and genetic abnormalities. It has two main types; NHL which is more common than HL.
Prognosis of lymphoma depends on many factors, mainly the stage of the disease. There are multiple staging systems of lymphoma, however; Lugano staging system is a recent & simple classification system that consists of stages I & II (considered as limited disease) and stages III & IV (considered as advanced disease).
This study is a diagnostic test accuracy study where we examined 100 adult patients, pathologically proven to have untreated lymphoma, attended for initial assessment and staging by radiological imaging using CECT & 18F-FDG PET/CT scans.
The study included 61 males and 39 females whose ages ranged between 20 and 70 years with exclusion of patients with other malignancies, renal failure, pregnancy and hypersensitivity to contrast agents.
All patients were subjected to:
Full history and complete clinical examination including the clinical stage of the disease.
Laboratory blood samples examination: mainly renal function tests as creatinin clearance should be > 30, blood glucose level should be ensured to be below 200mg/dl and CBC.
Histo-pathological examination of taken biopsies proving lymphoma disease.
Radiological investigations including: low dose non contrast CT, whole body 18F-FDG PET scan using Hi-Definition Hi-resolution protocol &
CECT using 128-multislice CT scanner.
According to CECT & PET/CT; the number and distribution of the affected sites were detected then staging of lymphoma according the lugano classification was done, results were recorded and analyzed as follows:-
The studied group (100 lymphoma patients) showed higher percentage of male patients (61%) than female patients (39%). Patients of the age group (50- <60 years) showed the highest rate of affection (27%). Patients of the age groups (20-<30 & 30-<40 years) showed the least rate of affection (16% each).
NHL represented 66% of the cases in our study compared to 34% for HL. In NHL male affection (39%) was higher than female affection (27%). In HL male affection (22%) was higher than female affection 12%. The most affected age group by NHL (24%) was 50-<60 years, while the most affected age group by HL (12%) was 20-<30 years.
PET/CT diagnosed a total number of 545 involved regions with sensitivity 96.6%, specificity 98.8% & accuracy 99% which was higher than CECT that diagnosed 439 involved regions with sensitivity 87.5%, specificity 85.7% & accuracy 88%.
Regarding lymph nodal involvement: PET/CT detected 312 true positive nodal group involvements with sensitivity 97.5%, specificity 94% & accuracy 98%. This was higher than CECT that detected 266 true positive nodal group involvements with sensitivity 83.1%, specificity 94% & accuracy 89.6% denoting a significant difference (P >0.005). There were 46 false negative lymph node groups on CECT, but as for PET/CT they were only 3 groups. The most common involved lymph node group was the abdomino-pelvic group (74% by PET/CT and 67% by CECT) & the least common was the inguinal group (45 % by PET/CT and 40% by CECT).