1988 Volume 49 Issue 4 Pages 716-722
A 56-year-old male who had chief complaints of abdominal distention and general fatigue during therapy for liver cirrhosis was diagnosed as having primary splenic malignant lymphoma by echography, computed tomography, angiography and other examination procedures. He was treated by splenectomy and chemotherapy. The lesion, localized in the spleen which was 18×10×6 cm in size, had a tumor in its lower pole. The cut surface of the tumor was nodular and whitish-yellow and was demarcated clearly within the intact spleen. The pathological finding of this tumor was immunoblastic, plasmacytoid, B cell-type malignant lymphoma according to A Working Formulation of Non-Hodgkin's Lymphomas for Clinical Usage.
Ninety-eight cases of primary splenic malignant lymphoma have been reported in Japan. The ages of the patients ranged from 14 to 75 years (average 48.8 years), and the male-to-female ratio was 2.2:1. Most patients had chief complaints of pain and palpable tumor in the left subcostal region. They developed severe splenomegaly 4-45 cm (average 13.4 cm) in size and 280-4500 g (average 1440 g) in weight. Most of them were treated by splenectomy, but their prognosis was mostly poor.
It should be emphasized that primary splenic lymphomas can be diagnosed with certainty preoperatively by imaging methods, and that they should be classified pathologically according to A Working Formulation of Non-Hodgkin's Lymphomas for Clinical Usage, considering their therapy and prognosis.
