Splenectomy for diagnosis of lymphomas: A case series

Abstract

Splenomegaly can be caused by various etiologies such as infections, congestion/ portal hypertension, auto-immune diseases, infiltrative diseases and malignancy. It requires extensive work-up of hematological, radiological and sometimes bone marrow studies to arrive at definitive diagnosis. However, in 3-36% of cases, cause of splenomegaly remains unknown despite extensive work up; among which lymphomas (16-44%) are an important cause. Hence splenectomy and pathological examination of the spleen might be the only option in this sub-set of patients to confirm the diagnosis. Here is a series of four cases of splenomegaly of unknown etiology presented to us over a period of 3 years who underwent laparoscopic splenectomy for diagnostic purpose. All these cases were diagnosed as Non-Hodgkin's lymphoma. Thrombocytopenia, anaemia and symptoms due to mass effect that these patients had prior to surgery were reversed. All patients were started on chemotherapy with-in 4 weeks of surgery.

Keywords

• splenomegaly
• lymphomas
• splenomegaly of unknown etiology
• non-hodgkin's lymphoma
• primary splenic lymphomas