Surgical management of moderate to high myopia

Faculty Medicine Year: 2006
Type of Publication: Theses Pages: 164
Authors:
BibID 3201173
Keywords : Surgical management , moderate , high myopia    
Abstract:
SUMMARYAs refractive surgery gets simpler, safer, more predictable and more effective, it becomes more popular. While cases of simple myopia are usually easy to handle and get satisfactory results when corrected with excimer laser, those with high myopia still represent some challenges.To get the best possible outcome, the surgical plan should be tailored individually to suit each particular case with its peculiar characteristics regarding patients age, activities, visual needs, expectations and of course not the least his own eye parameters.In an attempt to better understand this issue, this study was conducted including ninety eyes of 48 patients, 22 males (45.8 %) and 26 (54.2%) females with a mean age of 40.66±12.03 (range 20 to 63) years and mean spherical equivalent of -12.67±4.64 (range -24 to -7.5) diopters. They were divided into three equal groups.The first group (A) underwent phakic intraocular lens implantation namely Kelman duet lens which is an angle supported anterior chamber phakic lens with rigid tripod haptic and foldable optic that can be injected through a self sealed clear corneal incision of as small size as two mm to be assembled to the previously implanted haptic.The second group (B) under went LASIK after doing the necessary investigations to exclude keratoconus suspects and to make sure that the cornea has enough thickness to allow complete correction of the refractive error in an ablation diameter that matches the scotopic pupil size.The third group (C) underwent clear lens extraction using micro-incision cataract surgery followed by implantation of acrylic foldable posterior chamber IOLs.The mean efficacy index three months postoperatively was 0.99, 0.874 and 0.916 in group A, B and C respectively. UCVA of 0.5 (6/12) or better was achieved in 80%, 93.33%, 63.3% of cases of group A, B and C respectively, while UCVA of 1.0 (6/6) was achieved in 16.67% and 33.3% of cases of group A and B.The mean postoperative safety index was 1.268, 1.03 and 1.249 in group A, B and C respectively. BCVA of 0.5 (6/12) or better was achieved in all cases however, 50%, 60% and 26.67% of cases in group A, B and C respectively achieved postoperative BCVA of 1.0 (6/6)Postoperative spherical equivalent within one diopter of emmetropia was achieved in 76.67%, 86.67%, 70% of cases in group A, B and C respectively. Postoperative defocus equivalent equal to or less than one diopter was achieved in 50%, 80% and 60% of cases group A, B and C respectively.The contrast sensitivity curves improved in the first postoperative month in all spatial frequencies in cases of group A and C without significant change in the subsequent visits. However; in cases of group B the contrast sensitivity curves decreased in the first postoperative month in all spatial frequencies, then improved at the third month visit to the preoperative level to exceed it in the sixth month without significant change in the subsequent ninth month visit.There was transient rise in IOP in cases of group A and C during the first postoperative week however; in group B IOP showed significant decline all through the follow up period.There was statistically significant loss of endothelial cells at one and nine months postoperatively however, the degree of loss varied in different groups. The loss in the mean endothelial cell count from preoperative level to the first month postoperatively was 6.29%, 1.56% and 9.78% and from the first month to the ninth month postoperatively was 0.99%, 1.28% and 0.92% in group A, B and C respectively.Regarding complications; in group (A), 6.67% of cases developed mild intraoperative hyphaema. Pupil ovalization occurred in 6.67% of cases, In 3.33% of cases rotation of the lens occurred due to too short haptics. In group (B), 3.33% of cases had decentered flap 3.33 % had decentered ablation. Interface deposits as well as bleeding to the interface were observed in 6.67%. The incidence of epithelial ingrowth, DLK and flap stria was 3.33% where as that of pseudoDLK was 6.67%. while in group (C), 3.33% of cases had intraoperative iris trauma while developed 6.67% posterior capsule opacification.CONCLUSIONSurgical correction of moderate to high myopia proved to be effective, safe and predictable. The choice of the procedure should be based on the patient’s condition, the surgeon’s expertise as well as the resources of the health care facility. The main procedures for correction of high myopia are Phakic IOLs, LASIK and clear lens extraction. Each of these procedures has its own indications, precautions as well as its most feared complications.Phakic IOLs despite the excellent initial outcome in terms of predictability and quality of vision imply certain risk for endothelial damage therefore should be followed up regularly. Phakic IOL should be removed as soon as serious decline in endothelial cell density occurs. As large proportion of high myopes will develop cataract, care should be taken to interfere before endothelial cell count decreases below safe limit for performing cataract extraction. The younger the patient at time of PIOL implantation, the higher the endothelial cell count required before PIOL implantation.LASIK is less invasive but irreversible procedure. Concerns about LASIK include degradation in quality of vision especially with marked flattening of the cornea which directly increases the higher order aberrations, the compromise between the optical zone and the possible correction respecting the minimal residual stromal bed. At any cost the risk of post LASIK keratectasia, the most devastating complication of LASIK nowadays, should be minimized. It should be kept in mind that theoretical calculations do not make up for the common error in the flap thickness.Clear lens extraction is more appealing in patients over forty five years especially if there is lens sclerosis as phakic IOL may enhance the cataract. LASIK also complicates IOL calculation should cataract progress necessitating removal. CLE should be performed through as small incision as possible to decrease the fluctuation in anterior chamber depth. Complete cortical clean up as well as capsular polishing must be performed to decrease the incidence of posterior capsular opacification and consequently YAG laser capsulotomy which is a very important added risk factor for retinal detachment in high myopes.Finally, due to the possible risks and elective nature of these procedures, they should only be offered to patients who refuse glasses and do not tolerate contact lenses. Clear explanation and proper informed consent is mandatory in every case.SUMMARYAs refractive surgery gets simpler, safer, more predictable and more effective, it becomes more popular. While cases of simple myopia are usually easy to handle and get satisfactory results when corrected with excimer laser, those with high myopia still represent some challenges.To get the best possible outcome, the surgical plan should be tailored individually to suit each particular case with its peculiar characteristics regarding patients age, activities, visual needs, expectations and of course not the least his own eye parameters.In an attempt to better understand this issue, this study was conducted including ninety eyes of 48 patients, 22 males (45.8 %) and 26 (54.2%) females with a mean age of 40.66±12.03 (range 20 to 63) years and mean spherical equivalent of -12.67±4.64 (range -24 to -7.5) diopters. They were divided into three equal groups.The first group (A) underwent phakic intraocular lens implantation namely Kelman duet lens which is an angle supported anterior chamber phakic lens with rigid tripod haptic and foldable optic that can be injected through a self sealed clear corneal incision of as small size as two mm to be assembled to the previously implanted haptic.The second group (B) under went LASIK after doing the necessary investigations to exclude keratoconus suspects and to make sure that the cornea has enough thickness to allow complete correction of the refractive error in an ablation diameter that matches the scotopic pupil size.The third group (C) underwent clear lens extraction using micro-incision cataract surgery followed by implantation of acrylic foldable posterior chamber IOLs.The mean efficacy index three months postoperatively was 0.99, 0.874 and 0.916 in group A, B and C respectively. UCVA of 0.5 (6/12) or better was achieved in 80%, 93.33%, 63.3% of cases of group A, B and C respectively, while UCVA of 1.0 (6/6) was achieved in 16.67% and 33.3% of cases of group A and B.The mean postoperative safety index was 1.268, 1.03 and 1.249 in group A, B and C respectively. BCVA of 0.5 (6/12) or better was achieved in all cases however, 50%, 60% and 26.67% of cases in group A, B and C respectively achieved postoperative BCVA of 1.0 (6/6)The results of these diagnostic modalities were recorded, analyzed and compared to the final diagnosis. Which was based on clinical follow up and histopathological findings.From the study we can conclude the following points:? HD and NHL may involve any organ or organ system where lymphoid tissue is found.? US are modalities of choice for the initial imaging of the abdomen and pelvis in children, the technique is non-invasive and? most children can be examined without sedation. The lack of exposure to radiation is important and examination can be repeated at frequent interval if required.? Sensitivity in the detection of different groups of lymph node enlargement is definitely higher using CT (100%) than US (70%).? Regarding accuracy in the evaluation of extranodal lymphoma CT was better than US with a sensitivity of (95%) and specificity of (90.9%). CT in addition to visualizing lymph node enlargement, offer more information about the extent of the lesion with involvement of the intra-abdominal nodes and extranodal organs.? On gastrointestinal lymphoma US can be used as an initial approach whenever there is a clinical suspicion of the intestinal lymphoma. However, the US demonstration of the small bowel loops may be obscured by over lying air in the adjacent loops, there fore, negative US findings cannot excluded the diagnosis of intestinal lymphoma, with a sensitivity of (55.6%) and specificity of (71.4%).? Regarding gastrointestinal lymphoma CT has been proven to be more sensitive than US in revealing bowel wall thickening with sensitivity of (100%), so CT must be performed for staging of the disease and assessment of the extension of the mass.Summary and ConclusionThis study included 30 patients, they were 20 males and 10 females and their age ranged from 1 year to 15 years old.Detailed personal history was taken, full clinical examination and laboratory investigation were performed prior imaging.Abdominal distention was the most common presentation seen in 53.3% of cases.Ultrasonography and abdominal computed tomograhpy were performed in all cases.NHL accounts for about 63.3% of cases and HD for about 36.7% of cases.The results of these diagnostic modalities were recorded, analyzed and compared to the final diagnosis. Which was based on clinical follow up and histopathological findings.From the study we can conclude the following points:? HD and NHL may involve any organ or organ system where lymphoid tissue is found.? US are modalities of choice for the initial imaging of the abdomen and pelvis in children, the technique is non-invasive and? most children can be examined without sedation. The lack of exposure to radiation is important and examination can be repeated at frequent interval if required.? Sensitivity in the detection of different groups of lymph node enlargement is definitely higher using CT (100%) than US (70%).? Regarding accuracy in the evaluation of extranodal lymphoma CT was better than US with a sensitivity of (95%) and specificity of (90.9%). CT in addition to visualizing lymph node enlargement, offer more information about the extent of the lesion with involvement of the intra-abdominal nodes and extranodal organs.? On gastrointestinal lymphoma US can be used as an initial approach whenever there is a clinical suspicion of the intestinal lymphoma. However, the US demonstration of the small bowel loops may be obscured by over lying air in the adjacent loops, there fore, negative US findings cannot excluded the diagnosis of intestinal lymphoma, with a sensitivity of (55.6%) and specificity of (71.4%).? Regarding gastrointestinal lymphoma CT has been proven to be more sensitive than US in revealing bowel wall thickening with sensitivity of (100%), so CT must be performed for staging of the disease and assessment of the extension of the mass.Summary and ConclusionThis study included 30 patients, they were 20 males and 10 females and their age ranged from 1 year to 15 years old.Detailed personal history was taken, full clinical examination and laboratory investigation were performed prior imaging.Abdominal distention was the most common presentation seen in 53.3% of cases.Ultrasonography and abdominal computed tomograhpy were performed in all cases.NHL accounts for about 63.3% of cases and HD for about 36.7% of cases.The results of these diagnostic modalities were recorded, analyzed and compared to the final diagnosis. Which was based on clinical follow up and histopathological findings.From the study we can conclude the following points:? HD and NHL may involve any organ or organ system where lymphoid tissue is found.? US are modalities of choice for the initial imaging of the abdomen and pelvis in children, the technique is non-invasive and? most children can be examined without sedation. The lack of exposure to radiation is important and examination can be repeated at frequent interval if required.? Sensitivity in the detection of different groups of lymph node enlargement is definitely higher using CT (100%) than US (70%).? Regarding accuracy in the evaluation of extranodal lymphoma CT was better than US with a sensitivity of (95%) and specificity of (90.9%). CT in addition to visualizing lymph node enlargement, offer more information about the extent of the lesion with involvement of the intra-abdominal nodes and extranodal organs.? On gastrointestinal lymphoma US can be used as an initial approach whenever there is a clinical suspicion of the intestinal lymphoma. However, the US demonstration of the small bowel loops may be obscured by over lying air in the adjacent loops, there fore, negative US findings cannot excluded the diagnosis of intestinal lymphoma, with a sensitivity of (55.6%) and specificity of (71.4%).? Regarding gastrointestinal lymphoma CT has been proven to be more sensitive than US in revealing bowel wall thickening with sensitivity of (100%), so CT must be performed for staging of the disease and assessment of the extension of the mass.Summary and ConclusionThis study included 30 patients, they were 20 males and 10 females and their age ranged from 1 year to 15 years old.Detailed personal history was taken, full clinical examination and laboratory investigation were performed prior imaging.Abdominal distention was the most common presentation seen in 53.3% of cases.Ultrasonography and abdominal computed tomograhpy were performed in all cases.NHL accounts for about 63.3% of cases and HD for about 36.7% of cases.The results of these diagnostic modalities were recorded, analyzed and compared to the final diagnosis. Which was based on clinical follow up and histopathological findings.From the study we can conclude the following points:? HD and NHL may involve any organ or organ system where lymphoid tissue is found.? US are modalities of choice for the initial imaging of the abdomen and pelvis in children, the technique is non-invasive and? most children can be examined without sedation. The lack of exposure to radiation is important and examination can be repeated at frequent interval if required.? Sensitivity in the detection of different groups of lymph node enlargement is definitely higher using CT (100%) than US (70%).? Regarding accuracy in the evaluation of extranodal lymphoma CT was better than US with a sensitivity of (95%) and specificity of (90.9%). CT in addition to visualizing lymph node enlargement, offer more information about the extent of the lesion with involvement of the intra-abdominal nodes and extranodal organs.? On gastrointestinal lymphoma US can be used as an initial approach whenever there is a clinical suspicion of the intestinal lymphoma. However, the US demonstration of the small bowel loops may be obscured by over lying air in the adjacent loops, there fore, negative US findings cannot excluded the diagnosis of intestinal lymphoma, with a sensitivity of (55.6%) and specificity of (71.4%).? Regarding gastrointestinal lymphoma CT has been proven to be more sensitive than US in revealing bowel wall thickening with sensitivity of (100%), so CT must be performed for staging of the disease and assessment of the extension of the mass.Summary and ConclusionThis study included 30 patients, they were 20 males and 10 females and their age ranged from 1 year to 15 years old.Detailed personal history was taken, full clinical examination and laboratory investigation were performed prior imaging.Abdominal distention was the most common presentation seen in 53.3% of cases.Ultrasonography and abdominal computed tomograhpy were performed in all cases.NHL accounts for about 63.3% of cases and HD for about 36.7% of cases.The results of these diagnostic modalities were recorded, analyzed and compared to the final diagnosis. Which was based on clinical follow up and histopathological findings.From the study we can conclude the following points:? HD and NHL may involve any organ or organ system where lymphoid tissue is found.? US are modalities of choice for the initial imaging of the abdomen and pelvis in children, the technique is non-invasive and? most children can be examined without sedation. The lack of exposure to radiation is important and examination can be repeated at frequent interval if required.? Sensitivity in the detection of different groups of lymph node enlargement is definitely higher using CT (100%) than US (70%).? Regarding accuracy in the evaluation of extranodal lymphoma CT was better than US with a sensitivity of (95%) and specificity of (90.9%). CT in addition to visualizing lymph node enlargement, offer more information about the extent of the lesion with involvement of the intra-abdominal nodes and extranodal organs.? On gastrointestinal lymphoma US can be used as an initial approach whenever there is a clinical suspicion of the intestinal lymphoma. However, the US demonstration of the small bowel loops may be obscured by over lying air in the adjacent loops, there fore, negative US findings cannot excluded the diagnosis of intestinal lymphoma, with a sensitivity of (55.6%) and specificity of (71.4%).? Regarding gastrointestinal lymphoma CT has been proven to be more sensitive than US in revealing bowel wall thickening with sensitivity of (100%), so CT must be performed for staging of the disease and assessment of the extension of the mass.Summary and ConclusionThis study included 30 patients, they were 20 males and 10 females and their age ranged from 1 year to 15 years old.Detailed personal history was taken, full clinical examination and laboratory investigation were performed prior imaging.Abdominal distention was the most common presentation seen in 53.3% of cases.Ultrasonography and abdominal computed tomograhpy were performed in all cases.NHL accounts for about 63.3% of cases and HD for about 36.7% of cases.The results of these diagnostic modalities were recorded, analyzed and compared to the final diagnosis. Which was based on clinical follow up and histopathological findings.From the study we can conclude the following points:? HD and NHL may involve any organ or organ system where lymphoid tissue is found.? US are modalities of choice for the initial imaging of the abdomen and pelvis in children, the technique is non-invasive and? most children can be examined without sedation. The lack of exposure to radiation is important and examination can be repeated at frequent interval if required.? Sensitivity in the detection of different groups of lymph node enlargement is definitely higher using CT (100%) than US (70%).? Regarding accuracy in the evaluation of extranodal lymphoma CT was better than US with a sensitivity of (95%) and specificity of (90.9%). CT in addition to visualizing lymph node enlargement, offer more information about the extent of the lesion with involvement of the intra-abdominal nodes and extranodal organs.? On gastrointestinal lymphoma US can be used as an initial approach whenever there is a clinical suspicion of the intestinal lymphoma. However, the US demonstration of the small bowel loops may be obscured by over lying air in the adjacent loops, there fore, negative US findings cannot excluded the diagnosis of intestinal lymphoma, with a sensitivity of (55.6%) and specificity of (71.4%).? Regarding gastrointestinal lymphoma CT has been proven to be more sensitive than US in revealing bowel wall thickening with sensitivity of (100%), so CT must be performed for staging of the disease and assessment of the extension of the mass.Summary and ConclusionThis study included 30 patients, they were 20 males and 10 females and their age ranged from 1 year to 15 years old.Detailed personal history was taken, full clinical examination and laboratory investigation were performed prior imaging.Abdominal distention was the most common presentation seen in 53.3% of cases.Ultrasonography and abdominal computed tomograhpy were performed in all cases.NHL accounts for about 63.3% of cases and HD for about 36.7% of cases.The results of these diagnostic modalities were recorded, analyzed and compared to the final diagnosis. Which was based on clinical follow up and histopathological findings.From the study we can conclude the following points:? HD and NHL may involve any organ or organ system where lymphoid tissue is found.? US are modalities of choice for the initial imaging of the abdomen and pelvis in children, the technique is non-invasive and? most children can be examined without sedation. The lack of exposure to radiation is important and examination can be repeated at frequent interval if required.? Sensitivity in the detection of different groups of lymph node enlargement is definitely higher using CT (100%) than US (70%).? Regarding accuracy in the evaluation of extranodal lymphoma CT was better than US with a sensitivity of (95%) and specificity of (90.9%). CT in addition to visualizing lymph node enlargement, offer more information about the extent of the lesion with involvement of the intra-abdominal nodes and extranodal organs.? On gastrointestinal lymphoma US can be used as an initial approach whenever there is a clinical suspicion of the intestinal lymphoma. However, the US demonstration of the small bowel loops may be obscured by over lying air in the adjacent loops, there fore, negative US findings cannot excluded the diagnosis of intestinal lymphoma, with a sensitivity of (55.6%) and specificity of (71.4%).? Regarding gastrointestinal lymphoma CT has been proven to be more sensitive than US in revealing bowel wall thickening with sensitivity of (100%), so CT must be performed for staging of the disease and assessment of the extension of the mass.Summary and ConclusionThis study included 30 patients, they were 20 males and 10 females and their age ranged from 1 year to 15 years old.Detailed personal history was taken, full clinical examination and laboratory investigation were performed prior imaging.Abdominal distention was the most common presentation seen in 53.3% of cases.Ultrasonography and abdominal computed tomograhpy were performed in all cases.NHL accounts for about 63.3% of cases and HD for about 36.7% of cases.The results of these diagnostic modalities were recorded, analyzed and compared to the final diagnosis. Which was based on clinical follow up and histopathological findings.From the study we can conclude the following points:? HD and NHL may involve any organ or organ system where lymphoid tissue is found.? US are modalities of choice for the initial imaging of the abdomen and pelvis in children, the technique is non-invasive and? most children can be examined without sedation. The lack of exposure to radiation is important and examination can be repeated at frequent interval if required.? Sensitivity in the detection of different groups of lymph node enlargement is definitely higher using CT (100%) than US (70%).? Regarding accuracy in the evaluation of extranodal lymphoma CT was better than US with a sensitivity of (95%) and specificity of (90.9%). CT in addition to visualizing lymph node enlargement, offer more information about the extent of the lesion with involvement of the intra-abdominal nodes and extranodal organs.? On gastrointestinal lymphoma US can be used as an initial approach whenever there is a clinical suspicion of the intestinal lymphoma. However, the US demonstration of the small bowel loops may be obscured by over lying air in the adjacent loops, there fore, negative US findings cannot excluded the diagnosis of intestinal lymphoma, with a sensitivity of (55.6%) and specificity of (71.4%).? Regarding gastrointestinal lymphoma CT has been proven to be more sensitive than US in revealing bowel wall thickening with sensitivity of (100%), so CT must be performed for staging of the disease and assessment of the extension of the mass.Summary and ConclusionThis study included 30 patients, they were 20 males and 10 females and their age ranged from 1 year to 15 years old.Detailed personal history was taken, full clinical examination and laboratory investigation were performed prior imaging.Abdominal distention was the most common presentation seen in 53.3% of cases.Ultrasonography and abdominal computed tomograhpy were performed in all cases.NHL accounts for about 63.3% of cases and HD for about 36.7% of cases.The results of these diagnostic modalities were recorded, analyzed and compared to the final diagnosis. Which was based on clinical follow up and histopathological findings.From the study we can conclude the following points:? HD and NHL may involve any organ or organ system where lymphoid tissue is found.? US are modalities of choice for the initial imaging of the abdomen and pelvis in children, the technique is non-invasive and? most children can be examined without sedation. The lack of exposure to radiation is important and examination can be repeated at frequent interval if required.? Sensitivity in the detection of different groups of lymph node enlargement is definitely higher using CT (100%) than US (70%).? Regarding accuracy in the evaluation of extranodal lymphoma CT was better than US with a sensitivity of (95%) and specificity of (90.9%). CT in addition to visualizing lymph node enlargement, offer more information about the extent of the lesion with involvement of the intra-abdominal nodes and extranodal organs.? On gastrointestinal lymphoma US can be used as an initial approach whenever there is a clinical suspicion of the intestinal lymphoma. However, the US demonstration of the small bowel loops may be obscured by over lying air in the adjacent loops, there fore, negative US findings cannot excluded the diagnosis of intestinal lymphoma, with a sensitivity of (55.6%) and specificity of (71.4%).? Regarding gastrointestinal lymphoma CT has been proven to be more sensitive than US in revealing bowel wall thickening with sensitivity of (100%), so CT must be performed for staging of the disease and assessment of the extension of the mass.Summary and ConclusionThis study included 30 patients, they were 20 males and 10 females and their age ranged from 1 year to 15 years old.Detailed personal history was taken, full clinical examination and laboratory investigation were performed prior imaging.Abdominal distention was the most common presentation seen in 53.3% of cases.Ultrasonography and abdominal computed tomograhpy were performed in all cases.NHL accounts for about 63.3% of cases and HD for about 36.7% of cases.The results of these diagnostic modalities were recorded, analyzed and compared to the final diagnosis. Which was based on clinical follow up and histopathological findings.From the study we can conclude the following points:? HD and NHL may involve any organ or organ system where lymphoid tissue is found.? US are modalities of choice for the initial imaging of the abdomen and pelvis in children, the technique is non-invasive and? most children can be examined without sedation. The lack of exposure to radiation is important and examination can be repeated at frequent interval if required.? Sensitivity in the detection of different groups of lymph node enlargement is definitely higher using CT (100%) than US (70%).? Regarding accuracy in the evaluation of extranodal lymphoma CT was better than US with a sensitivity of (95%) and specificity of (90.9%). CT in addition to visualizing lymph node enlargement, offer more information about the extent of the lesion with involvement of the intra-abdominal nodes and extranodal organs.? On gastrointestinal lymphoma US can be used as an initial approach whenever there is a clinical suspicion of the intestinal lymphoma. However, the US demonstration of the small bowel loops may be obscured by over lying air in the adjacent loops, there fore, negative US findings cannot excluded the diagnosis of intestinal lymphoma, with a sensitivity of (55.6%) and specificity of (71.4%).? Regarding gastrointestinal lymphoma CT has been proven to be more sensitive than US in revealing bowel wall thickening with sensitivity of (100%), so CT must be performed for staging of the disease and assessment of the extension of the mass.Summary and ConclusionThis study included 30 patients, they were 20 males and 10 females and their age ranged from 1 year to 15 years old.Detailed personal history was taken, full clinical examination and laboratory investigation were performed prior imaging.Abdominal distention was the most common presentation seen in 53.3% of cases.Ultrasonography and abdominal computed tomograhpy were performed in all cases.NHL accounts for about 63.3% of cases and HD for about 36.7% of cases.The results of these diagnostic modalities were recorded, analyzed and compared to the final diagnosis. Which was based on clinical follow up and histopathological findings.From the study we can conclude the following points:? HD and NHL may involve any organ or organ system where lymphoid tissue is found.? US are modalities of choice for the initial imaging of the abdomen and pelvis in children, the technique is non-invasive and? most children can be examined without sedation. The lack of exposure to radiation is important and examination can be repeated at frequent interval if required.? Sensitivity in the detection of different groups of lymph node enlargement is definitely higher using CT (100%) than US (70%).? Regarding accuracy in the evaluation of extranodal lymphoma CT was better than US with a sensitivity of (95%) and specificity of (90.9%). CT in addition to visualizing lymph node enlargement, offer more information about the extent of the lesion with involvement of the intra-abdominal nodes and extranodal organs.? On gastrointestinal lymphoma US can be used as an initial approach whenever there is a clinical suspicion of the intestinal lymphoma. However, the US demonstration of the small bowel loops may be obscured by over lying air in the adjacent loops, there fore, negative US findings cannot excluded the diagnosis of intestinal lymphoma, with a sensitivity of (55.6%) and specificity of (71.4%).? Regarding gastrointestinal lymphoma CT has been proven to be more sensitive than US in revealing bowel wall thickening with sensitivity of (100%), so CT must be performed for staging of the disease and assessment of the extension of the mass.Summary and ConclusionThis study included 30 patients, they were 20 males and 10 females and their age ranged from 1 year to 15 years old.Detailed personal history was taken, full clinical examination and laboratory investigation were performed prior imaging.Abdominal distention was the most common presentation seen in 53.3% of cases.Ultrasonography and abdominal computed tomograhpy were performed in all cases.NHL accounts for about 63.3% of cases and HD for about 36.7% of cases.The results of these diagnostic modalities were recorded, analyzed and compared to the final diagnosis. Which was based on clinical follow up and histopathological findings.From the study we can conclude the following points:? HD and NHL may involve any organ or organ system where lymphoid tissue is found.? US are modalities of choice for the initial imaging of the abdomen and pelvis in children, the technique is non-invasive and? most children can be examined without sedation. The lack of exposure to radiation is important and examination can be repeated at frequent interval if required.? Sensitivity in the detection of different groups of lymph node enlargement is definitely higher using CT (100%) than US (70%).? Regarding accuracy in the evaluation of extranodal lymphoma CT was better than US with a sensitivity of (95%) and specificity of (90.9%). CT in addition to visualizing lymph node enlargement, offer more information about the extent of the lesion with involvement of the intra-abdominal nodes and extranodal organs.? On gastrointestinal lymphoma US can be used as an initial approach whenever there is a clinical suspicion of the intestinal lymphoma. However, the US demonstration of the small bowel loops may be obscured by over lying air in the adjacent loops, there fore, negative US findings cannot excluded the diagnosis of intestinal lymphoma, with a sensitivity of (55.6%) and specificity of (71.4%).? Regarding gastrointestinal lymphoma CT has been proven to be more sensitive than US in revealing bowel wall thickening with sensitivity of (100%), so CT must be performed for staging of the disease and assessment of the extension of the mass.Summary and ConclusionThis study included 30 patients, they were 20 males and 10 females and their age ranged from 1 year to 15 years old.Detailed personal history was taken, full clinical examination and laboratory investigation were performed prior imaging.Abdominal distention was the most common presentation seen in 53.3% of cases.Ultrasonography and abdominal computed tomograhpy were performed in all cases.NHL accounts for about 63.3% of cases and HD for about 36.7% of cases.The results of these diagnostic modalities were recorded, analyzed and compared to the final diagnosis. Which was based on clinical follow up and histopathological findings.From the study we can conclude the following points:? HD and NHL may involve any organ or organ system where lymphoid tissue is found.? US are modalities of choice for the initial imaging of the abdomen and pelvis in children, the technique is non-invasive and? most children can be examined without sedation. The lack of exposure to radiation is important and examination can be repeated at frequent interval if required.? Sensitivity in the detection of different groups of lymph node enlargement is definitely higher using CT (100%) than US (70%).? Regarding accuracy in the evaluation of extranodal lymphoma CT was better than US with a sensitivity of (95%) and specificity of (90.9%). CT in addition to visualizing lymph node enlargement, offer more information about the extent of the lesion with involvement of the intra-abdominal nodes and extranodal organs.? On gastrointestinal lymphoma US can be used as an initial approach whenever there is a clinical suspicion of the intestinal lymphoma. However, the US demonstration of the small bowel loops may be obscured by over lying air in the adjacent loops, there fore, negative US findings cannot excluded the diagnosis of intestinal lymphoma, with a sensitivity of (55.6%) and specificity of (71.4%).? Regarding gastrointestinal lymphoma CT has been proven to be more sensitive than US in revealing bowel wall thickening with sensitivity of (100%), so CT must be performed for staging of the disease and assessment of the extension of the mass.Summary and ConclusionThis study included 30 patients, they were 20 males and 10 females and their age ranged from 1 year to 15 years old.Detailed personal history was taken, full clinical examination and laboratory investigation were performed prior imaging.Abdominal distention was the most common presentation seen in 53.3% of cases.Ultrasonography and abdominal computed tomograhpy were performed in all cases.NHL accounts for about 63.3% of cases and HD for about 36.7% of cases.The results of these diagnostic modalities were recorded, analyzed and compared to the final diagnosis. Which was based on clinical follow up and histopathological findings.From the study we can conclude the following points:? HD and NHL may involve any organ or organ system where lymphoid tissue is found.? US are modalities of choice for the initial imaging of the abdomen and pelvis in children, the technique is non-invasive and? most children can be examined without sedation. The lack of exposure to radiation is important and examination can be repeated at frequent interval if required.? Sensitivity in the detection of different groups of lymph node enlargement is definitely higher using CT (100%) than US (70%).? Regarding accuracy in the evaluation of extranodal lymphoma CT was better than US with a sensitivity of (95%) and specificity of (90.9%). CT in addition to visualizing lymph node enlargement, offer more information about the extent of the lesion with involvement of the intra-abdominal nodes and extranodal organs.? On gastrointestinal lymphoma US can be used as an initial approach whenever there is a clinical suspicion of the intestinal lymphoma. However, the US demonstration of the small bowel loops may be obscured by over lying air in the adjacent loops, there fore, negative US findings cannot excluded the diagnosis of intestinal lymphoma, with a sensitivity of (55.6%) and specificity of (71.4%).? Regarding gastrointestinal lymphoma CT has been proven to be more sensitive than US in revealing bowel wall thickening with sensitivity of (100%), so CT must be performed for staging of the disease and assessment of the extension of the mass.Summary and ConclusionThis study included 30 patients, they were 20 males and 10 females and their age ranged from 1 year to 15 years old.Detailed personal history was taken, full clinical examination and laboratory investigation were performed prior imaging.Abdominal distention was the most common presentation seen in 53.3% of cases.Ultrasonography and abdominal computed tomograhpy were performed in all cases.NHL accounts for about 63.3% of cases and HD for about 36.7% of cases.The results of these diagnostic modalities were recorded, analyzed and compared to the final diagnosis. Which was based on clinical follow up and histopathological findings.From the study we can conclude the following points:? HD and NHL may involve any organ or organ system where lymphoid tissue is found.? US are modalities of choice for the initial imaging of the abdomen and pelvis in children, the technique is non-invasive and? most children can be examined without sedation. The lack of exposure to radiation is important and examination can be repeated at frequent interval if required.? Sensitivity in the detection of different groups of lymph node enlargement is definitely higher using CT (100%) than US (70%).? Regarding accuracy in the evaluation of extranodal lymphoma CT was better than US with a sensitivity of (95%) and specificity of (90.9%). CT in addition to visualizing lymph node enlargement, offer more information about the extent of the lesion with involvement of the intra-abdominal nodes and extranodal organs.? On gastrointestinal lymphoma US can be used as an initial approach whenever there is a clinical suspicion of the intestinal lymphoma. However, the US demonstration of the small bowel loops may be obscured by over lying air in the adjacent loops, there fore, negative US findings cannot excluded the diagnosis of intestinal lymphoma, with a sensitivity of (55.6%) and specificity of (71.4%).? Regarding gastrointestinal lymphoma CT has been proven to be more sensitive than US in revealing bowel wall thickening with sensitivity of (100%), so CT must be performed for staging of the disease and assessment of the extension of the mass.Summary and ConclusionThis study included 30 patients, they were 20 males and 10 females and their age ranged from 1 year to 15 years old.Detailed personal history was taken, full clinical examination and laboratory investigation were performed prior imaging.Abdominal distention was the most common presentation seen in 53.3% of cases.Ultrasonography and abdominal computed tomograhpy were performed in all cases.NHL accounts for about 63.3% of cases and HD for about 36.7% of cases.The results of these diagnostic modalities were recorded, analyzed and compared to the final diagnosis. Which was based on clinical follow up and histopathological findings.From the study we can conclude the following points:? HD and NHL may involve any organ or organ system where lymphoid tissue is found.? US are modalities of choice for the initial imaging of the abdomen and pelvis in children, the technique is non-invasive and? most children can be examined without sedation. The lack of exposure to radiation is important and examination can be repeated at frequent interval if required.? Sensitivity in the detection of different groups of lymph node enlargement is definitely higher using CT (100%) than US (70%).? Regarding accuracy in the evaluation of extranodal lymphoma CT was better than US with a sensitivity of (95%) and specificity of (90.9%). CT in addition to visualizing lymph node enlargement, offer more information about the extent of the lesion with involvement of the intra-abdominal nodes and extranodal organs.? On gastrointestinal lymphoma US can be used as an initial approach whenever there is a clinical suspicion of the intestinal lymphoma. However, the US demonstration of the small bowel loops may be obscured by over lying air in the adjacent loops, there fore, negative US findings cannot excluded the diagnosis of intestinal lymphoma, with a sensitivity of (55.6%) and specificity of (71.4%).? Regarding gastrointestinal lymphoma CT has been proven to be more sensitive than US in revealing bowel wall thickening with sensitivity of (100%), so CT must be performed for staging of the disease and assessment of the extension of the mass.Summary and ConclusionThis study included 30 patients, they were 20 males and 10 females and their age ranged from 1 year to 15 years old.Detailed personal history was taken, full clinical examination and laboratory investigation were performed prior imaging.Abdominal distention was the most common presentation seen in 53.3% of cases.Ultrasonography and abdominal computed tomograhpy were performed in all cases.NHL accounts for about 63.3% of cases and HD for about 36.7% of cases.The results of these diagnostic modalities were recorded, analyzed and compared to the final diagnosis. Which was based on clinical follow up and histopathological findings.From the study we can conclude the following points:? HD and NHL may involve any organ or organ system where lymphoid tissue is found.? US are modalities of choice for the initial imaging of the abdomen and pelvis in children, the technique is non-invasive and? most children can be examined without sedation. The lack of exposure to radiation is important and examination can be repeated at frequent interval if required.? Sensitivity in the detection of different groups of lymph node enlargement is definitely higher using CT (100%) than US (70%).? Regarding accuracy in the evaluation of extranodal lymphoma CT was better than US with a sensitivity of (95%) and specificity of (90.9%). CT in addition to visualizing lymph node enlargement, offer more information about the extent of the lesion with involvement of the intra-abdominal nodes and extranodal organs.? On gastrointestinal lymphoma US can be used as an initial approach whenever there is a clinical suspicion of the intestinal lymphoma. However, the US demonstration of the small bowel loops may be obscured by over lying air in the adjacent loops, there fore, negative US findings cannot excluded the diagnosis of intestinal lymphoma, with a sensitivity of (55.6%) and specificity of (71.4%).? Regarding gastrointestinal lymphoma CT has been proven to be more sensitive than US in revealing bowel wall thickening with sensitivity of (100%), so CT must be performed for staging of the disease and assessment of the extension of the mass.Summary and ConclusionThis study included 30 patients, they were 20 males and 10 females and their age ranged from 1 year to 15 years old.Detailed personal history was taken, full clinical examination and laboratory investigation were performed prior imaging.Abdominal distention was the most common presentation seen in 53.3% of cases.Ultrasonography and abdominal computed tomograhpy were performed in all cases.NHL accounts for about 63.3% of cases and HD for about 36.7% of cases.The results of these diagnostic modalities were recorded, analyzed and compared to the final diagnosis. Which was based on clinical follow up and histopathological findings.From the study we can conclude the following points:? HD and NHL may involve any organ or organ system where lymphoid tissue is found.? US are modalities of choice for the initial imaging of the abdomen and pelvis in children, the technique is non-invasive and? most children can be examined without sedation. The lack of exposure to radiation is important and examination can be repeated at frequent interval if required.? Sensitivity in the detection of different groups of lymph node enlargement is definitely higher using CT (100%) than US (70%).? Regarding accuracy in the evaluation of extranodal lymphoma CT was better than US with a sensitivity of (95%) and specificity of (90.9%). CT in addition to visualizing lymph node enlargement, offer more information about the extent of the lesion with involvement of the intra-abdominal nodes and extranodal organs.? On gastrointestinal lymphoma US can be used as an initial approach whenever there is a clinical suspicion of the intestinal lymphoma. However, the US demonstration of the small bowel loops may be obscured by over lying air in the adjacent loops, there fore, negative US findings cannot excluded the diagnosis of intestinal lymphoma, with a sensitivity of (55.6%) and specificity of (71.4%).? Regarding gastrointestinal lymphoma CT has been proven to be more sensitive than US in revealing bowel wall thickening with sensitivity of (100%), so CT must be performed for staging of the disease and assessment of the extension of the mass.Summary and ConclusionThis study included 30 patients, they were 20 males and 10 females and their age ranged from 1 year to 15 years old.Detailed personal history was taken, full clinical examination and laboratory investigation were performed prior imaging.Abdominal distention was the most common presentation seen in 53.3% of cases.Ultrasonography and abdominal computed tomograhpy were performed in all cases.NHL accounts for about 63.3% of cases and HD for about 36.7% of cases.The results of these diagnostic modalities were recorded, analyzed and compared to the final diagnosis. Which was based on clinical follow up and histopathological findings.From the study we can conclude the following points:? HD and NHL may involve any organ or organ system where lymphoid tissue is found.? US are modalities of choice for the initial imaging of the abdomen and pelvis in children, the technique is non-invasive and? most children can be examined without sedation. The lack of exposure to radiation is important and examination can be repeated at frequent interval if required.? Sensitivity in the detection of different groups of lymph node enlargement is definitely higher using CT (100%) than US (70%).? Regarding accuracy in the evaluation of extranodal lymphoma CT was better than US with a sensitivity of (95%) and specificity of (90.9%). CT in addition to visualizing lymph node enlargement, offer more information about the extent of the lesion with involvement of the intra-abdominal nodes and extranodal organs.? On gastrointestinal lymphoma US can be used as an initial approach whenever there is a clinical suspicion of the intestinal lymphoma. However, the US demonstration of the small bowel loops may be obscured by over lying air in the adjacent loops, there fore, negative US findings cannot excluded the diagnosis of intestinal lymphoma, with a sensitivity of (55.6%) and specificity of (71.4%).? Regarding gastrointestinal lymphoma CT has been proven to be more sensitive than US in revealing bowel wall thickening with sensitivity of (100%), so CT must be performed for staging of the disease and assessment of the extension of the mass.Summary and ConclusionThis study included 30 patients, they were 20 males and 10 females and their age ranged from 1 year to 15 years old.Detailed personal history was taken, full clinical examination and laboratory investigation were performed prior imaging.Abdominal distention was the most common presentation seen in 53.3% of cases.Ultrasonography and abdominal computed tomograhpy were performed in all cases.NHL accounts for about 63.3% of cases and HD for about 36.7% of cases.The results of these diagnostic modalities were recorded, analyzed and compared to the final diagnosis. Which was based on clinical follow up and histopathological findings.From the study we can conclude the following points:? HD and NHL may involve any organ or organ system where lymphoid tissue is found.? US are modalities of choice for the initial imaging of the abdomen and pelvis in children, the technique is non-invasive and? most children can be examined without sedation. The lack of exposure to radiation is important and examination can be repeated at frequent interval if required.? Sensitivity in the detection of different groups of lymph node enlargement is definitely higher using CT (100%) than US (70%).? Regarding accuracy in the evaluation of extranodal lymphoma CT was better than US with a sensitivity of (95%) and specificity of (90.9%). CT in addition to visualizing lymph node enlargement, offer more information about the extent of the lesion with involvement of the intra-abdominal nodes and extranodal organs.? On gastrointestinal lymphoma US can be used as an initial approach whenever there is a clinical suspicion of the intestinal lymphoma. However, the US demonstration of the small bowel loops may be obscured by over lying air in the adjacent loops, there fore, negative US findings cannot excluded the diagnosis of intestinal lymphoma, with a sensitivity of (55.6%) and specificity of (71.4%).? Regarding gastrointestinal lymphoma CT has been proven to be more sensitive than US in revealing bowel wall thickening with sensitivity of (100%), so CT must be performed for staging of the disease and assessment of the extension of the mass.Summary and ConclusionThis study included 30 patients, they were 20 males and 10 females and their age ranged from 1 year to 15 years old.Detailed personal history was taken, full clinical examination and laboratory investigation were performed prior imaging.Abdominal distention was the most common presentation seen in 53.3% of cases.Ultrasonography and abdominal computed tomograhpy were performed in all cases.NHL accounts for about 63.3% of cases and HD for about 36.7% of cases.The results of these diagnostic modalities were recorded, analyzed and compared to the final diagnosis. Which was based on clinical follow up and histopathological findings.From the study we can conclude the following points:? HD and NHL may involve any organ or organ system where lymphoid tissue is found.? US are modalities of choice for the initial imaging of the abdomen and pelvis in children, the technique is non-invasive and? most children can be examined without sedation. The lack of exposure to radiation is important and examination can be repeated at frequent interval if required.? Sensitivity in the detection of different groups of lymph node enlargement is definitely higher using CT (100%) than US (70%).? Regarding accuracy in the evaluation of extranodal lymphoma CT was better than US with a sensitivity of (95%) and specificity of (90.9%). CT in addition to visualizing lymph node enlargement, offer more information about the extent of the lesion with involvement of the intra-abdominal nodes and extranodal organs.? On gastrointestinal lymphoma US can be used as an initial approach whenever there is a clinical suspicion of the intestinal lymphoma. However, the US demonstration of the small bowel loops may be obscured by over lying air in the adjacent loops, there fore, negative US findings cannot excluded the diagnosis of intestinal lymphoma, with a sensitivity of (55.6%) and specificity of (71.4%).? Regarding gastrointestinal lymphoma CT has been proven to be more sensitive than US in revealing bowel wall thickening with sensitivity of (100%), so CT must be performed for staging of the disease and assessment of the extension of the mass.Summary and ConclusionThis study included 30 patients, they were 20 males and 10 females and their age ranged from 1 year to 15 years old.Detailed personal history was taken, full clinical examination and laboratory investigation were performed prior imaging.Abdominal distention was the most common presentation seen in 53.3% of cases.Ultrasonography and abdominal computed tomograhpy were performed in all cases.NHL accounts for about 63.3% of cases and HD for about 36.7% of cases.The results of these diagnostic modalities were recorded, analyzed and compared to the final diagnosis. Which was based on clinical follow up and histopathological findings.From the study we can conclude the following points:? HD and NHL may involve any organ or organ system where lymphoid tissue is found.? US are modalities of choice for the initial imaging of the abdomen and pelvis in children, the technique is non-invasive and? most children can be examined without sedation. The lack of exposure to radiation is important and examination can be repeated at frequent interval if required.? Sensitivity in the detection of different groups of lymph node enlargement is definitely higher using CT (100%) than US (70%).? Regarding accuracy in the evaluation of extranodal lymphoma CT was better than US with a sensitivity of (95%) and specificity of (90.9%). CT in addition to visualizing lymph node enlargement, offer more information about the extent of the lesion with involvement of the intra-abdominal nodes and extranodal organs.? On gastrointestinal lymphoma US can be used as an initial approach whenever there is a clinical suspicion of the intestinal lymphoma. However, the US demonstration of the small bowel loops may be obscured by over lying air in the adjacent loops, there fore, negative US findings cannot excluded the diagnosis of intestinal lymphoma, with a sensitivity of (55.6%) and specificity of (71.4%).? Regarding gastrointestinal lymphoma CT has been proven to be more sensitive than US in revealing bowel wall thickening with sensitivity of (100%), so CT must be performed for staging of the disease and assessment of the extension of the mass.Summary and ConclusionThis study included 30 patients, they were 20 males and 10 females and their age ranged from 1 year to 15 years old.Detailed personal history was taken, full clinical examination and laboratory investigation were performed prior imaging.Abdominal distention was the most common presentation seen in 53.3% of cases.Ultrasonography and abdominal computed tomograhpy were performed in all cases.NHL accounts for about 63.3% of cases and HD for about 36.7% of cases.The results of these diagnostic modalities were recorded, analyzed and compared to the final diagnosis. Which was based on clinical follow up and histopathological findings.From the study we can conclude the following points:? HD and NHL may involve any organ or organ system where lymphoid tissue is found.? US are modalities of choice for the initial imaging of the abdomen and pelvis in children, the technique is non-invasive and? most children can be examined without sedation. The lack of exposure to radiation is important and examination can be repeated at frequent interval if required.? Sensitivity in the detection of different groups of lymph node enlargement is definitely higher using CT (100%) than US (70%).? Regarding accuracy in the evaluation of extranodal lymphoma CT was better than US with a sensitivity of (95%) and specificity of (90.9%). CT in addition to visualizing lymph node enlargement, offer more information about the extent of the lesion with involvement of the intra-abdominal nodes and extranodal organs.? On gastrointestinal lymphoma US can be used as an initial approach whenever there is a clinical suspicion of the intestinal lymphoma. However, the US demonstration of the small bowel loops may be obscured by over lying air in the adjacent loops, there fore, negative US findings cannot excluded the diagnosis of intestinal lymphoma, with a sensitivity of (55.6%) and specificity of (71.4%).? Regarding gastrointestinal lymphoma CT has been proven to be more sensitive than US in revealing bowel wall thickening with sensitivity of (100%), so CT must be performed for staging of the disease and assessment of the extension of the mass.Summary and ConclusionThis study included 30 patients, they were 20 males and 10 females and their age ranged from 1 year to 15 years old.Detailed personal history was taken, full clinical examination and laboratory investigation were performed prior imaging.Abdominal distention was the most common presentation seen in 53.3% of cases.Ultrasonography and abdominal computed tomograhpy were performed in all cases.NHL accounts for about 63.3% of cases and HD for about 36.7% of cases.The results of these diagnostic modalities were recorded, analyzed and compared to the final diagnosis. Which was based on clinical follow up and histopathological findings.From the study we can conclude the following points:? HD and NHL may involve any organ or organ system where lymphoid tissue is found.? US are modalities of choice for the initial imaging of the abdomen and pelvis in children, the technique is non-invasive and? most children can be examined without sedation. The lack of exposure to radiation is important and examination can be repeated at frequent interval if required.? Sensitivity in the detection of different groups of lymph node enlargement is definitely higher using CT (100%) than US (70%).? Regarding accuracy in the evaluation of extranodal lymphoma CT was better than US with a sensitivity of (95%) and specificity of (90.9%). CT in addition to visualizing lymph node enlargement, offer more information about the extent of the lesion with involvement of the intra-abdominal nodes and extranodal organs.? On gastrointestinal lymphoma US can be used as an initial approach whenever there is a clinical suspicion of the intestinal lymphoma. However, the US demonstration of the small bowel loops may be obscured by over lying air in the adjacent loops, there fore, negative US findings cannot excluded the diagnosis of intestinal lymphoma, with a sensitivity of (55.6%) and specificity of (71.4%).? Regarding gastrointestinal lymphoma CT has been proven to be more sensitive than US in revealing bowel wall thickening with sensitivity of (100%), so CT must be performed for staging of the disease and assessment of the extension of the mass.Summary and ConclusionThis study included 30 patients, they were 20 males and 10 females and their age ranged from 1 year to 15 years old.Detailed personal history was taken, full clinical examination and laboratory investigation were performed prior imaging.Abdominal distention was the most common presentation seen in 53.3% of cases.Ultrasonography and abdominal computed tomograhpy were performed in all cases.NHL accounts for about 63.3% of cases and HD for about 36.7% of cases.The results of these diagnostic modalities were recorded, analyzed and compared to the final diagnosis. Which was based on clinical follow up and histopathological findings.From the study we can conclude the following points:? HD and NHL may involve any organ or organ system where lymphoid tissue is found.? US are modalities of choice for the initial imaging of the abdomen and pelvis in children, the technique is non-invasive and? most children can be examined without sedation. The lack of exposure to radiation is important and examination can be repeated at frequent interval if required.? Sensitivity in the detection of different groups of lymph node enlargement is definitely higher using CT (100%) than US (70%).? Regarding accuracy in the evaluation of extranodal lymphoma CT was better than US with a sensitivity of (95%) and specificity of (90.9%). CT in addition to visualizing lymph node enlargement, offer more information about the extent of the lesion with involvement of the intra-abdominal nodes and extranodal organs.? On gastrointestinal lymphoma US can be used as an initial approach whenever there is a clinical suspicion of the intestinal lymphoma. However, the US demonstration of the small bowel loops may be obscured by over lying air in the adjacent loops, there fore, negative US findings cannot excluded the diagnosis of intestinal lymphoma, with a sensitivity of (55.6%) and specificity of (71.4%).? Regarding gastrointestinal lymphoma CT has been proven to be more sensitive than US in revealing bowel wall thickening with sensitivity of (100%), so CT must be performed for staging of the disease and assessment of the extension of the mass.Summary and ConclusionThis study included 30 patients, they were 20 males and 10 females and their age ranged from 1 year to 15 years old.Detailed personal history was taken, full clinical examination and laboratory investigation were performed prior imaging.Abdominal distention was the most common presentation seen in 53.3% of cases.Ultrasonography and abdominal computed tomograhpy were performed in all cases.NHL accounts for about 63.3% of cases and HD for about 36.7% of cases.The results of these diagnostic modalities were recorded, analyzed and compared to the final diagnosis. Which was based on clinical follow up and histopathological findings.From the study we can conclude the following points:? HD and NHL may involve any organ or organ system where lymphoid tissue is found.? US are modalities of choice for the initial imaging of the abdomen and pelvis in children, the technique is non-invasive and? most children can be examined without sedation. The lack of exposure to radiation is important and examination can be repeated at frequent interval if required.? Sensitivity in the detection of different groups of lymph node enlargement is definitely higher using CT (100%) than US (70%).? Regarding accuracy in the evaluation of extranodal lymphoma CT was better than US with a sensitivity of (95%) and specificity of (90.9%). CT in addition to visualizing lymph node enlargement, offer more information about the extent of the lesion with involvement of the intra-abdominal nodes and extranodal organs.? On gastrointestinal lymphoma US can be used as an initial approach whenever there is a clinical suspicion of the intestinal lymphoma. However, the US demonstration of the small bowel loops may be obscured by over lying air in the adjacent loops, there fore, negative US findings cannot excluded the diagnosis of intestinal lymphoma, with a sensitivity of (55.6%) and specificity of (71.4%).? Regarding gastrointestinal lymphoma CT has been proven to be more sensitive than US in revealing bowel wall thickening with sensitivity of (100%), so CT must be performed for staging of the disease and assessment of the extension of the mass.Summary and ConclusionThis study included 30 patients, they were 20 males and 10 females and their age ranged from 1 year to 15 years old.Detailed personal history was taken, full clinical examination and laboratory investigation were performed prior imaging.Abdominal distention was the most common presentation seen in 53.3% of cases.Ultrasonography and abdominal computed tomograhpy were performed in all cases.NHL accounts for about 63.3% of cases and HD for about 36.7% of cases.The results of these diagnostic modalities were recorded, analyzed and compared to the final diagnosis. Which was based on clinical follow up and histopathological findings.From the study we can conclude the following points:? HD and NHL may involve any organ or organ system where lymphoid tissue is found.? US are modalities of choice for the initial imaging of the abdomen and pelvis in children, the technique is non-invasive and? most children can be examined without sedation. The lack of exposure to radiation is important and examination can be repeated at frequent interval if required.? Sensitivity in the detection of different groups of lymph node enlargement is definitely higher using CT (100%) than US (70%).? Regarding accuracy in the evaluation of extranodal lymphoma CT was better than US with a sensitivity of (95%) and specificity of (90.9%). CT in addition to visualizing lymph node enlargement, offer more information about the extent of the lesion with involvement of the intra-abdominal nodes and extranodal organs.? On gastrointestinal lymphoma US can be used as an initial approach whenever there is a clinical suspicion of the intestinal lymphoma. However, the US demonstration of the small bowel loops may be obscured by over lying air in the adjacent loops, there fore, negative US findings cannot excluded the diagnosis of intestinal lymphoma, with a sensitivity of (55.6%) and specificity of (71.4%).? Regarding gastrointestinal lymphoma CT has been proven to be more sensitive than US in revealing bowel wall thickening with sensitivity of (100%), so CT must be performed for staging of the disease and assessment of the extension of the mass.Summary and ConclusionThis study included 30 patients, they were 20 males and 10 females and their age ranged from 1 year to 15 years old.Detailed personal history was taken, full clinical examination and laboratory investigation were performed prior imaging.Abdominal distention was the most common presentation seen in 53.3% of cases.Ultrasonography and abdominal computed tomograhpy were performed in all cases.NHL accounts for about 63.3% of cases and HD for about 36.7% of cases.The results of these diagnostic modalities were recorded, analyzed and compared to the final diagnosis. Which was based on clinical follow up and histopathological findings.From the study we can conclude the following points:? HD and NHL may involve any organ or organ system where lymphoid tissue is found.? US are modalities of choice for the initial imaging of the abdomen and pelvis in children, the technique is non-invasive and? most children can be examined without sedation. The lack of exposure to radiation is important and examination can be repeated at frequent interval if required.? Sensitivity in the detection of different groups of lymph node enlargement is definitely higher using CT (100%) than US (70%).? Regarding accuracy in the evaluation of extranodal lymphoma CT was better than US with a sensitivity of (95%) and specificity of (90.9%). CT in addition to visualizing lymph node enlargement, offer more information about the extent of the lesion with involvement of the intra-abdominal nodes and extranodal organs.? On gastrointestinal lymphoma US can be used as an initial approach whenever there is a clinical suspicion of the intestinal lymphoma. However, the US demonstration of the small bowel loops may be obscured by over lying air in the adjacent loops, there fore, negative US findings cannot excluded the diagnosis of intestinal lymphoma, with a sensitivity of (55.6%) and specificity of (71.4%).? Regarding gastrointestinal lymphoma CT has been proven to be more sensitive than US in revealing bowel wall thickening with sensitivity of (100%), so CT must be performed for staging of the disease and assessment of the extension of the mass.Summary and ConclusionThis study included 30 patients, they were 20 males and 10 females and their age ranged from 1 year to 15 years old.Detailed personal history was taken, full clinical examination and laboratory investigation were performed prior imaging.Abdominal distention was the most common presentation seen in 53.3% of cases.Ultrasonography and abdominal computed tomograhpy were performed in all cases.NHL accounts for about 63.3% of cases and HD for about 36.7% of cases.The results of these diagnostic modalities were recorded, analyzed and compared to the final diagnosis. Which was based on clinical follow up and histopathological findings.From the study we can conclude the following points:? HD and NHL may involve any organ or organ system where lymphoid tissue is found.? US are modalities of choice for the initial imaging of the abdomen and pelvis in children, the technique is non-invasive and? most children can be examined without sedation. The lack of exposure to radiation is important and examination can be repeated at frequent interval if required.? Sensitivity in the detection of different groups of lymph node enlargement is definitely higher using CT (100%) than US (70%).? Regarding accuracy in the evaluation of extranodal lymphoma CT was better than US with a sensitivity of (95%) and specificity of (90.9%). CT in addition to visualizing lymph node enlargement, offer more information about the extent of the lesion with involvement of the intra-abdominal nodes and extranodal organs.? On gastrointestinal lymphoma US can be used as an initial approach whenever there is a clinical suspicion of the intestinal lymphoma. However, the US demonstration of the small bowel loops may be obscured by over lying air in the adjacent loops, there fore, negative US findings cannot excluded the diagnosis of intestinal lymphoma, with a sensitivity of (55.6%) and specificity of (71.4%).? Regarding gastrointestinal lymphoma CT has been proven to be more sensitive than US in revealing bowel wall thickening with sensitivity of (100%), so CT must be performed for staging of the disease and assessment of the extension of the mass.Summary and ConclusionThis study included 30 patients, they were 20 males and 10 females and their age ranged from 1 year to 15 years old.Detailed personal history was taken, full clinical examination and laboratory investigation were performed prior imaging.Abdominal distention was the most common presentation seen in 53.3% of cases.Ultrasonography and abdominal computed tomograhpy were performed in all cases.NHL accounts for about 63.3% of cases and HD for about 36.7% of cases.The results of these diagnostic modalities were recorded, analyzed and compared to the final diagnosis. Which was based on clinical follow up and histopathological findings.From the study we can conclude the following points:? HD and NHL may involve any organ or organ system where lymphoid tissue is found.? US are modalities of choice for the initial imaging of the abdomen and pelvis in children, the technique is non-invasive and? most children can be examined without sedation. The lack of exposure to radiation is important and examination can be repeated at frequent interval if required.? Sensitivity in the detection of different groups of lymph node enlargement is definitely higher using CT (100%) than US (70%).? Regarding accuracy in the evaluation of extranodal lymphoma CT was better than US with a sensitivity of (95%) and specificity of (90.9%). CT in addition to visualizing lymph node enlargement, offer more information about the extent of the lesion with involvement of the intra-abdominal nodes and extranodal organs.? On gastrointestinal lymphoma US can be used as an initial approach whenever there is a clinical suspicion of the intestinal lymphoma. However, the US demonstration of the small bowel loops may be obscured by over lying air in the adjacent loops, there fore, negative US findings cannot excluded the diagnosis of intestinal lymphoma, with a sensitivity of (55.6%) and specificity of (71.4%).? Regarding gastrointestinal lymphoma CT has been proven to be more sensitive than US in revealing bowel wall thickening with sensitivity of (100%), so CT must be performed for staging of the disease and assessment of the extension of the mass.2- Group II: included 10 normal volunteers.Our patients were collected according to the American Rheumatism Association (ARA) revised criteria for classification of SLE (Tan, et al., 1982) and their age ranged from (16-45) ys.All patients were subjected to full history taking with stress on arthritis or arthralgia, fever, vasculitic changes, Loin pain, dysuria, seizures, headache or psychosis.We divided our SLE patients according to disease activity index into 2 groups: table (2)Group I: inactive 56.7%.Group II: Active 43.3% : a- Mild active 23.3%b- Moderate active 10%.c-Severe active 10%.We redivided them according to renal involvement into 4 subgroups as follow:(I) Inactive: a- With renal involvement (23.3%).b- Without renal involvement (33.3%).(II) Active;a -With renal involvement (20/%)b-With out renal involvement (23.3%)Table (3)All patients were clinically examined with stress on: General examination, joint examination, skin rash, cardiovascular and chest examination, oedema of L.L., lymphadenopathy.All cases were subjected to laboratory investigations including:1- Complete blood picture.2- Erythrocytic sedementation rate.3- Complete urine analysis.4- Kidney function tests.5- 24 hour proteinuria.6- ANA.7- Anti DNA antibody.8- Liver function tests.9- Fasting blood sugar.10- Plain x ray pelvis & chest.11- Urinary glycosaminoglycans levels (ion exchange chromatography on DEAE- Sephacel) including HS & CS levels. by (Enzyme-linked immunosorbent assay)The following results were obtained:- Among clinical cnaracteristicas of disease activity in our SLE patients Raynaud’s phenomenon was the most common feature (33.3%) while pyrexia and serositis both affected only 3.3% of patients.- ESR level was higher in sever active patients anti DNA titres were higher in active SLE patients than inactive ones .- CS and Hs levels were higher in severe active patients- Ahighly significant difference between positive and negative cases of arthralgia, vasculitic skin rash and lymphadenopathy as regard total urinary GAG level. There was significant difference between positive and negative cases of Raynaud’s phenomenon and neuropsychiatric manifestations as regard total urinary GAG level while there was no statistical difference between positive and negative cases for pyrexia, seroitis and bleeding tendency as regard total urinary GAG level.- Non significant correlation between urinary GAG level and other laboratory parameter: including ESR, Anti DNA, 24 hour proteinuria and creatinine level.- A significant elevation of total urinary GAG in SLE patients compared to control group.- A significant elevation of urinary HS in SLE patients compared to control group while there is no statistical difference between the two groups as regard CS level.- A highly significant difference between SLE patients and control group as regard CS/HS ratio.- A significant elevation of total urinary GAG in active SLE patients with extrarenal disease compared to inactive patients.- A significant elevation of HS and CS levels in active SLE patients compared to inactive patients.- A significant difference between active SLE and inactive patients as regard CS/HS ratio.ConclusionIn conclusion, we believe that analysis of urinary GAG may represent an additional, non invasive diagnostic approach in SLE patients because it might indicate the presence of an early abnormal permeability of the renal filter in patients without other appreciable signs of kidney alteration. 
   
     
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