American Board of Internal Medicine (ABIM) Certification Practice Exam

What provides important prognostic information in patients with Hodgkin lymphoma following treatment?

1. CT scans

2. Bone marrow biopsy

3. Early repeat PET scan

4. Physical examination

The correct answer is: Early repeat PET scan

Early repeat PET scans provide crucial prognostic information in patients with Hodgkin lymphoma following treatment. The use of positron emission tomography (PET) scans is instrumental in assessing the metabolic activity of any remaining lymphoma after initial therapy. A PET scan evaluates the uptake of a radiotracer, which highlights areas of increased metabolic activity associated with tumor cells. If the repeat PET scan shows a complete metabolic response, it generally correlates with a favorable long-term prognosis. Conversely, persistent metabolic activity suggests residual disease, which can indicate a higher risk of relapse and may necessitate further therapy or alternative treatment strategies. While CT scans can provide anatomical information and help assess the size and location of lymph nodes, they lack the sensitivity of PET scans in detecting metabolic activity. Similarly, bone marrow biopsies can give insights into disease involvement but are not routinely performed after treatment for prognostic purposes. Physical examination helps to monitor general health and physical status but does not provide definitive prognostic indicators regarding the response to treatment. Thus, the early repeat PET scan is pivotal in determining the outcome and guiding ongoing management of Hodgkin lymphoma patients post-treatment.