EBVD combination chemotherapy plus low dose involved field radiation is a highly effective treatment modality for early stage Hodgkin's disease.

To evaluate the efficacy of EBVD combination chemotherapy followed by low dose (LD) involved field (IF) radiation therapy (RT) in patients with clinical stage (CS) I-IIA Hodgkin's disease (HD), we analyzed 148 patients treated in our Unit from March 1988 to November 1995. EBVD consisted of Epirubicine 40 mg/m2, Bleomycin 10 mg/m2, Vinblastine 6 mg/m2 and Dacarbazine 300 mg. All drugs were administered i.v. at days 1 and 15, every 4 weeks, for a total of 4-6 cycles. LDIF RT (24-32 Gy) was scheduled for patients with complete response (CR) or >90% reduction of tumor load, after EBVD. Patients with stable or progressive disease (SD, PD) after EBVDx3 or poor compliance to the regimen received mantle or inverted Y RT at standard dose. The median follow-up of patients currently alive was 71.5 months. 129 patients achieved a CR after EBVD and 10 a >90% reduction of tumor load, for a post-CT response rate of 94%. Eight patients had SD after EBVDx3 and one had a partial response with poor compliance. All 9 patients received mantle or inverted Y RT and 8/9 achieved a CR. Nine patients relapsed at a median of 7 months from the end of treatment. At 10 years, FFS was 90% and overall survival 95%. Six patients have died so far; 5 of HD and one of stroke. One patient developed a diffuse large cell lymphoma 48 months after the diagnosis of HD. We conclude that EBVD followed by LDIF RT is a highly effective regimen for patients with CS I-IIA HD. Longer follow up is required to assess the risk of secondary malignancies, especially solid tumors.

MRI of nasopharyngeal carcinoma metastatic to the cerebellopontine angle.

In patients with nasopharyngeal carcinoma, intracranial spread may occur via direct extension from the base of the skull or via perineural spread. Perineural spread usually affects branches of the trigeminal nerve. We describe two patients with recurrent nasopharyngeal carcinoma, who presented with a solitary mass in the cerebellopontine angle without associated bony destruction. MRI findings mimicked those of acoustic schwannoma. The imaging findings and possible pathways of spread are discussed.

Digital subtraction angiography in the evaluation of chemodectomas.

During the last 2 years eleven patients with surgically confirmed chemodectomas have been investigated by means of digital subtraction angiography (DSA). Seven patients underwent i.v. DSA, which revealed eight carotid body tumours, and in the remaining four with jugulotympanic chemodectomas intra-arterial (i.a.) DSA was performed. We found i.V. DSA an easy and satisfactory method for the investigation of carotid body tumours but when glomus intravagale, tympanicum or jugulare is suspected an i.a. selective injection is required.

Computed tomography in the evaluation of spinal aneurysmal bone cyst.

Computed tomographic findings in three cases of aneurysmal bone cyst (ABC) are reported. Although conventional radiography is usually adequate in the demonstration of an expansile osteolytic cavity, CT may provide additional information about tumour characteristics, localization and extent, show the lesion's relation to the spinal cord and thus be of great help in preoperative planning.

CT characterization of multivesicular hydatid cysts.

One hundred seventy-eight abdominal multivesicular hydatid cysts were classified into three types (A, B, C) based on CT densities and morphology of cysts. The CT density of viable daughter cysts was always appreciably lower than those of mother hydatid cysts. This density differential between mother and daughter hydatid cyst fluid is a useful diagnostic sign.

Tuberculosis of the spine. CT demonstration of paravertebral abscess.

Two surgically proven cases of tuberculous psoas abscess are presented. The common findings on CT were low-density paraspinal masses and extension of the lesions which followed the typical distribution of iliopsoas muscle in both cases. The skeletal findings from the spine are also discussed. Our cases indicate the complementary use of plain radiography and CT in the investigation of tuberculous spondylitis.

Detection of pericardial heart disease by computed tomography.

The findings on computed tomography (CT) in 10 cases of pericardial disease, nine of which were surgically confirmed, are presented. The 10th patient (Case 10), whose CT diagnosis was 'pericarditis', was found to have a myxosarcoma at surgery. In some of these cases, echocardiographic and conventional radiographic investigation gave inconclusive information regarding the underlying pathology. Our results support the conclusion that CT complements echocardiography: in the quantitative and qualitative assessment of pericardial effusions, in the localisation of space-occupying lesions involving the pericardium and in diagnosis of constrictive pericarditis. As echocardiography is so very much operator-dependent, CT may well be a more reliable method of obtaining a result which indicates both the diagnosis and the extent of the disease.