Progressive Mediastinal Widening After Therapy For Hodgkin’S Disease Association Of Hodgkin’S Disease With Sarcoidosis

Mantle irradiation is often part of the treatment for Hodgkin's disease. Localized pneumonitis and fibrosis are well-known sequelae of this treatment. We report nine patients with unusual thoracic radiographic findings following treatment for Hodgkin's disease. All nine had mediastinal widening. Seven of these patients received combined modality therapy in which prednisone was given with their MOPP. In these seven patients, an increase in mediastinal width developed at the same time as the radiographic changes of radiation pneumonitis. Two patients developed bilateral infiltrates extending beyond the field of radiation to the lung periphery. In one of these patients, a spontaneous pneumomediastinum developed. One patient underwent mediastinal biopsy that revealed inflammatory changes similar to those seen in radiation pneumonitis. All patients either responded to steroids or had spontaneous regression of radiographic abnormalities supporting the presumed diagnosis of treatment related changes. Recognition of these unusual sequelae of mantle irradiation will aid in differentiating them from infection or tumor and lead to prompt, appropriate treatment.

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Humoral hypercalcemia in Hodgkin's disease. Association with elevated 1,25-dihydroxycholecalciferol levels and subperiosteal bone resorption

Archives of Internal Medicine ◽

10.1001/archinte.145.1.155 ◽

1985 ◽

Vol 145 (1) ◽

pp. 155-157 ◽

Cited By ~ 5

Author(s):

G. P. Zaloga

Keyword(s):

Bone Resorption ◽

Hodgkin's Disease ◽

Hodgkin’S Disease ◽

Disease Association ◽

Humoral Hypercalcemia

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The significance of the residual mediastinal mass in treated Hodgkin's disease.

Journal of Clinical Oncology ◽

10.1200/jco.1985.3.5.637 ◽

1985 ◽

Vol 3 (5) ◽

pp. 637-640 ◽

Cited By ~ 93

Author(s):

M Jochelson ◽

P Mauch ◽

J Balikian ◽

D Rosenthal ◽

G Canellos

Keyword(s):

Hodgkin's Disease ◽

Hodgkin’S Disease ◽

Combined Modality Therapy ◽

Increased Risk ◽

Additional Chemotherapy ◽

Long Term Follow Up ◽

Mediastinal Widening ◽

Mediastinal Adenopathy ◽

One Year

The chest roentgenograms of 65 patients treated for Hodgkin's disease with mediastinal adenopathy were analyzed retrospectively to determine the incidence and significance of residual mediastinal abnormality after treatment. All patients were treated with radiation therapy, and 36 patients received additional chemotherapy. On completion of treatment, 57 (88%) of the 65 patients had some residual mediastinal abnormality. These were either minimal changes in the mediastinal shadow in 30 patients or a widening greater than 6 cm in 27 patients. In the latter group, 11 (40%) of 27 patients continued to have residual mediastinal widening one year after completion of therapy. These patients did not have a higher incidence of recurrence. Long-term follow-up (median, 48 months) revealed continued abnormalities in 24 (40%) of the original 57 patients. Mediastinal abnormalities are common at the end of radiation or combined modality therapy for Hodgkin's disease and do not by themselves indicate persistent active disease or an increased risk for relapse. We strongly recommend that additional chemotherapy or higher radiation doses beyond the initially planned course not be used for residual mediastinal widening.

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