Hodgkin's lymphoma x ray findings

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sowminya Arikapudi, M.B,B.S. [2]


Chest, spine, pelvic, and long bone x ray may be helpful in the diagnosis of Hodgkin's lymphoma.

X ray Findings

Chest, spine, pelvic, and long bone x ray may be helpful in the diagnosis of Hodgkin's lymphoma.[1] [2]

Chest x ray

  • Pulmonary involvement usually indicates stage IV Hodgkin's lymphoma
  • The mediastinal mass ratio can be determined by chest X-ray. A mediastinal mass ratio of greater than 0.33 is consistent with bulky disease.
  • The following findings on chest x ray may be suggestive of Hodgkin's lymphoma:
  • Masses
  • Mass-like consolidation
  • Diffuse interstitial thickening
  • Sternum may be involved
  • Ribs may be osteolytic and expansile
  • Bilateral involvement is seen in ~4% of cases
  • Mediastinal nodal involvement (Primary disease)
  • Pulmonary parenchymal involvement (Recurrent disease)
  • Peri bronchial infiltration may sometimes be observed

Spine x ray

  • Erosion of anterior or anterolateral aspect of the vertebral bodies is a classic finding in Hodgkin's lymphoma , caused by enlarged para vertebral lymph nodes
  • Nodular sclerosing Hodgkin's lymphoma shows diffusely increased density with our without anterior erosion; vertebral body height is unaffected
  • Single, dense vertebra (ivory vertebra) in adults
  • Intervertebral disc spaces are generally unaffected by the disease

Pelvic x ray

  • Mixed or sclerosing type predominates

Long bones x ray

  • Frequently lytic, extending along the long axis of bone through the medullary cavity with endosteal scalloping of the cortex


  1. Hodgkin lymphoma. Dr Amir Rezaee and Dr Yuranga Weerakkody et al. Radiopaedia.org 2015. http://radiopaedia.org/articles/hodgkin-lymphoma-pulmonary-manifestations
  2. Hodgkin lymphoma. Dr Henry Knipe and Asma J. Q. et al. Radiopaedia.org 2015. http://radiopaedia.org/articles/hodgkin-lymphoma-musculoskeletal-manifestations
  3. 3.0 3.1 Image courtesy of Dr Frank Gaillard Radiopaedia(original file ‘’here’’).Creative Commons BY-SA-NC

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