| Role in Treatment | Complications
Splenectomy is the surgical removal of
"A normal spleen is
approximately 11 cm in length, and is not easily palpable."
"The spleen helps the body fight
infection. Like the lymph nodes, the spleen contains
antibody-producing lymphocytes. These antibodies weaken or kill
bacteria, viruses, and other organisms that cause infection.
the blood passing through the spleen carries damaged cells, white
blood cells called macrophages in the spleen will destroy them and
clear them from the bloodstream."
Spleen image from MedlinePlus:
"Splenectomy, with an acceptable
surgical risk, has the potential to establish the diagnosis of NHL in
patients with splenomegaly (enlargement of the spleen) without
lymphadenopathy (enlarged lymph nodes) and negative bone marrow
Moreover, splenectomy has the capacity
to modify the disease course in patients with NHL complicated by AIHA
or hypersplenism." - Source PubMed
Source- Splenectomy in patients with malignant
non-Hodgkin's lymphoma. Eur J Haematol. 2000 Mar;64(3):145-50. PMID:
NEW: Laparoscopic splenectomy for splenic masses, 1 February 2008
The records for 174 patients who underwent laparoscopic
splenectomy from May 1994 to August 2006 were reviewed. ...
Conclusion of authors: Laparoscopic splenectomy is appropriate for
patients whose indication for surgery is splenic mass. Suspicious
splenic masses should be removed due to the relatively high
incidence of malignant pathology, most commonly lymphoma.
Residual splenomegaly in a patient who has otherwise
successfully responded in other sites following chemotherapy for
lymphoma is another reason for performing a splenectomy. In these
cases, the procedure may be performed for both diagnostic and
therapeutic reasons; it can determine if the splenomegaly is due
to persistent lymphoma, and should this be true, it can
potentially eliminate the focus of residual disease. A less common
indication for splenectomy that may be seen more frequently in the
future is to allow patients to become eligible for enrollment onto
novel treatment protocols. An example of this is in patients with
lymphoma refractory to conventional chemotherapy who were treated
with radioimmunotherapy using a radiolabelled anti-CD20 antibody.
In some of these patients, splenomegaly was found to complicate
treatment, as the large organ served as an “antigen sink”,
effectively decreasing the dose of radionuclide available to treat
other sites of disease. Thus, pretreatment splenectomy may be
indicated to eliminate this complicating factor.
Splenectomy and risk of infection
This leaflet aims to provide some important information which is
essential for lymphoma patients who have had their spleens
removed. It is taken from an article written by Drs Scott and
Richards. It has been revised with the help of one of our medical
advisors, Dr Paul Revell, Consultant Haematologist and Co-ordinator
of Cancer Services at Staffordshire General Hospital.
Value of FDG-PET in Prediction of Splenectomy Findings in
Patients with Suspected or Known Lymphoma
This study to our knowledge comprises the largest series to
evaluate splenic FDG-PET uptake in patients with suspected or
known lymphoma, followed by subsequent pathologic confirmation.
Patients with low splenic SUVs appear to be less likely to have
splenic involvement of lymphoma, while intermediate and high
values may correlate with lymphoma histology. Our findings support
a potential role for FDG-PET as a tool for use, in conjunction
with clinical and laboratory assessment, in consideration of the
need for splenectomy in these settings.
The Leukemic Presentation of Mantle-cell Lymphoma: Disease
Features and Prognostic Factors in 58 Patients. Leuk Lymphoma.
"This analysis demonstrates that except for
splenomegaly, survival of MCL patients presenting with leukemia is
not significantly influenced by clinical or tumor characteristics.
Splenectomy is a useful treatment option in this group of
Surgical Indications in Idiopathic (unknown cause of)
A high percentage of patients with splenomegaly of
unknown etiology will have primary lymphoma of the spleen. Splenectomy
is both diagnostic and therapeutic and should be considered
for all patients with idiopathic splenomegaly.
Role of in treatment
Laparoscopic Splenectomy for Malignant
Splenectomy in patients with malignant
Eur J Haematol. 2000 Mar;64(3):145-50. PMID: 10997879
Complications of splenectomy
Postoperative complications after splenectomy for
Ann Surg. 1996 Mar;223(3):290-6. PMID: 8604910