A CASE OF MALIGNANT LYMPHOMA, SUSPECTED OF ORIGINATING IN THE SPLEEN

Abstract

In a 67-year-old male patient, with chief complaint of left hypochondralgia, a tumor, which had grown to infant's head size, was found in the left upper abdomen. Abdominal computed tomography and celiac angiography revealed a hypovascular tumor and led to the diagnosis of splenic malignant lymphoma. Laparotomy disclosed that the splenic tumor invaded to the greater curvature of the stomach, the splenic flxure of the colon, the pancreas tail, and the left kidney. The tumor together with the invaded orgaans was resected en bloc. Histological diagnosis was diffuse lymphoma: large cell type according to the Lymphoma Study Group's classification. Nineteen cases of splenic malignant lymphoma with rupture or invasion to surrounding organs, which had occurred in Japan over the last 30 years, were reviewed. The period from the appearance of the first symptom to the operation was 4.6 months on the average, bacause of its rapid development. One report on the adjuvant chemotherapy prescribed one or two anticancer agents, but, the prognosis was so poor that 55% of the patients died within six months after the operation. To treat cases similar to this in the future, it is necessary to say much attention to the association between histological classification and treatment for obtaining better prognosis.