Splenectomy in patients with malignant non‐Hodgkin's lymphoma

Abstract

Splenectomy in patients with non-Hodgkin's lymphoma (NHL) is performed for either diagnostic or therapeutic reasons. We report on a series of 29 patients with NHL and splenomegaly who underwent splenectomy during the years 1979-1998 in our hospital. According to the indication for splenectomy our patients were categorized in three groups. Group A: In 20 patients splenectomy was performed for diagnostic reasons. Group B: Three patients were splenectomized for autoimmune haemolytic anaemia (AIHA). Group C: Six patients underwent splenectomy because of hypersplenism. A definitive histopathological diagnosis of NHL was obtained in all patients of group A. Hypersplenism and AIHA were resolved in all patients after splenectomy. One (3.5%) patient died postoperatively because of septicemia complicated by disseminated intravascular coagulation. Six postoperative complications were observed in 4 (14%) patients. Splenectomy, with an acceptable surgical risk, has the potential to establish the diagnosis of NHL in patients with splenomegaly without lymphadenopathy and negative bone marrow findings. Moreover, splenectomy has the capacity to modify the disease course in patients with NHL complicated by AIHA or hypersplenism.

Splenic Volume Change and Nodal Tumor Response in Non-Hodgkin's Lymphoma Patients after Radioimmunotherapy Using Radiolabeled Lym-1 Antibody

“…1 Splenic volume changes after RIT were found in the NHL patients who had enlarged spleens, a condition wherein histologic NHL involvement is more likely. In 28 NHL patients who had a splenic mass greater than 500 g and who underwent splenectomy, Xiros et al 27 found that 27 patients (96%) had histologic NHL involvement of the spleen. In our study, 13 NHL patients with splenic volumes of 380-1400 mL had splenic volume decreases of 70-550 mL after being associated with a low radiation dose to the spleen ( Table 2).…”

Primary splenic lymphoma presenting with ascites

“…Xiros et al maintain that the median survival after diagnostic splenectomy is 24 months regardless of disease stage or adjuvant chemotherapeutic regimen. 11 Treatment for PSL sparks debate due to the lack of clinical trials. Possible treatment modalities include splenectomy, local radiotherapy and systemic chemotherapy.…”

Splenectomy for hypersplenism caused by adult T-cell leukemia: Report of a case

“…In general, patients with malignant hematologic diseases have a high surgical risk, with morbidities after the splenectomy ranging from 3.5% to 61%. [13][14][15] The most common and serious complications include disseminated intravascular coagulation, portal vein thrombosis, pulmonary embolism, atelectasis, pleural effusion, subphrenic abscess, and postoperative hemorrhage. [16][17][18] A splenic weight greater than 3000 g poses an especially high risk for portal vein thrombosis, with an incidence of 50%.…”