Description

Muntanola et al described the use of abdominal CT to detect lymphadenopathy and/or splenomegaly in patients with Rai Stage 0 chronic lymphocytic leukemia (CLL). This can help identify a group of patients who are at increased risk for clinical progression and who may benefit from more aggressive management. The authors are from the University of Barcelona in Spain.


 

Rai Stage 0 CLL consists of lymphocytosis without lymphadenopathy or splenomegaly. Detection of either would indicate understaging based on the clinical examination.

 

Nodal groups examined:

(1) diaphragmatic

(2) celiac

(3) mesenteric

(4) iliac

(5) retroperitoneal (includes periaortic, interaortocaval, pericaval chains)

 

Criteria for lymphadenopathy in a group:

(1) single node with a maximum short axial diameter > 10 mm

(2) multiple enlarged group in a group with maximum short axial diameter <= 10 mm

 

Criteria for splenic enlargement: increase in any dimension with a change in the normal relationship with other abdominal viscera.

 

An abnormal CT scan was defines as one or both of the following:

(1) lymphadenopathy in >= 1 nodal group

(2) splenomegaly

 


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