STANLEY LOWENBRAUN, M.D.; HAROLD RAMSEY, M.D.; JOHN SUTHERLAND, M.D.; ARTHUR A. SERPICK, M.D., F.A.C.P.
Diagnostic laparotomies and splenectomies were performed on 12 patients to determine more accurately the extent of Hodgkin's disease in the abdomen. Preoperatively, the patients were carefully staged as recommended by the Rye Conference in 1966. At laparotomy four out of nine positive lymphograms were uncorroborated by surgical findings and biopsies, as was one positive inferior vena cavogram. Splenic disease was found in four out of six patients whose preoperative evaluations were negative in this regard. Hodgkin's infiltration of porta hepatic, splenic hilar, and mesenteric lymph nodes was found in three, two, and one patient, respectively. In one patient a retroperitoneal mass was discovered that extended 4 cm laterally to nodes visualized by lymphography and outside usual fields for radiotherapy. None of the hepatic wedge biopsies were positive. Three patients had their stages changed on the basis of laparotomy findings, and an additional seven patients had changes in their known extent of lymphomatous involvement.
LOWENBRAUN S, RAMSEY H, SUTHERLAND J, SERPICK AA. Diagnostic Laparotomy and Splenectomy for Staging Hodgkin's Disease. Ann Intern Med. ;72:655–663. doi: 10.7326/0003-4819-72-5-655
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Published: Ann Intern Med. 1970;72(5):655-663.
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