)In lymphomas the term "bulky" disease signifies a nodal mass whose greatest dimension is more than 10 centimeters in size, and/or a widening of the mediastinum by more than one-thirdThe above text clearly signifies that the highest levels of LDH are seen in bulky disease. INTERNATIONAL PROGNOSTIC INDEX:The International Prognostic Index (IPI) is a clinical tool developed by oncologists to aid in predicting the prognosis of patients with aggressive non-Hodgkin's lymphoma.One point is assigned for each of the following risk factors:Age greater than 60 yearsStage III or IV diseaseElevated serum LDHECOG/Zubrod performance status of 2, 3, or 4More than 1 extranodal siteThe sum of the points allotted correlates with the following risk groups:Low risk (0-1 points): 5-year survival of 73%LowT-intermediate risk (2 points): 5-year survival of 51%High-intermediate risk (3 points): 5-year survival of 43%High risk (4-5 points): 5-year survival of 26%LDH levels are raised in:Testicular carcinomaHemolytic anemiaVisceral infarctionLymphoma, LeukemiaPleural effusions and serositisMelanomaInterstitial lung diseasesMyopathiesMeningitis and encephalitisHIVDysgerminomaIncreased tissue turnover">