By B. W. Hancock, F. E. Neal (auth.), B. W. Hancock MD, DCH, MRCP (eds.)
The evaluation of tumour reaction after therapy is among the most crucial demanding situations in Oncology and the image is so frequently advanced by way of the results of treatment itself. scientific overview continues to be via some distance crucial approach to overview at our disposal yet there's expanding dependence on investigations of every kind as indices of reaction. This depen dence can be lost if beside the point investigations are pursued and we've got attempted to emphasize during this ebook the significance of selectivity. a few indices of review (e. g. tumour markers, organ imaging) have a necessary position to play; others (e. g. histopathology, genetics) are assuming better impor tance as tumour behaviour turns into larger understood. One topic, Immu nology, remains to be in its infancy as regards tumour follow-up, yet indicates a lot promise in order that a whole account of tumour immunology and tendencies in immu notherapy has been integrated. i'm thankful to Dr. Brian Ross for his aid with the bankruptcy on Organ Imaging, to the dept of clinical representation for his or her ever-ready co-operation with illustrations and images and to overlook Shirley Francis for doing a lot of the typing. B. W. HANCOCK checklist of individuals HANCOCK, B. W. , MD, DCH, MRCP, Senior Lecturer in medication, Hon orary advisor health care provider, Royal Hallamshire & Weston Park Hospitals, Sheffield, U. okay. NEAL, F. E. , KSG, MBChB, FRCR, DMRT, advisor Radiotherapist & Oncologist, Weston Park clinic, Sheffield, u. okay. POTTER, AM.
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Extra info for Assessment of Tumour Response
Nevertheless, there have been a number of reports of the value of ultrasound in assessing abdominal lymph node enlargement [22, 23]. Abdominal lymph nodes enlarged by tumour metastases or lymphoma deposits generally show enlargement with an almost trans-sonic appearance (Fig. 16) .. Response to treatment may be accompanied by shrinkage and by increased echogenicity. Occasionally treated nodes may fail to shrink but may become cystic and therefore trans-sonic. Lymphadenopathy may be detected in those areas where the nodes are unopacified by lymphography (Fig.
Barium meal : extrinsic compression of duodenum due to metastases from a testicular seminoma. Figure 37a. Barium swallow: carcinoma of the oesophagus. Figure 37b. Stricture much improved after radiotherapy. I VI Figure 38a. Lymphoma of caecum shown by barium enema examination. Figure 38h. Disappearance of tumour after chemotherapy. VI 00 59 13. Liver, spleen and pancreas The numerous ways now available to image these organs are mainly of recent development. The shadows of both liver and spleen appear on plain radiographs of the abdomen and may be of some value for the monitoring of tumour response.
It is apparent, however, from many lymphoma studies that conventional staging procedures including lymphography, seriously under-estimate the occurrence and extent of lymph node disease in the abdomen. It is also apparent that in some cases there may be an over-estimate, particularly in those patients with more advanced lymphomas. It is for these reasons that a diagnostic staging laparotomy has been widely adopted [17, 18, 19] , this also enabling a more accurate determination to be made of possible involvement of the liver and spleen.
Assessment of Tumour Response by B. W. Hancock, F. E. Neal (auth.), B. W. Hancock MD, DCH, MRCP (eds.)