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Treatment Overview > Splenectomy

Last update: 04/24/2010

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About | Role in Treatment | Complications of

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Splenectomy is the surgical removal of the spleen.    

 "A normal spleen is approximately 11 cm in length, and is not easily palpable." 3

"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.

Also, if 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."  gorhams.dk

Spleen image from MedlinePlus: http://www.nlm.nih.gov 

"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 findings. 

Moreover, splenectomy has the capacity to modify the disease course in patients with NHL complicated by AIHA or hypersplenism."  - Source PubMed

  1. Source-  Splenectomy in patients with malignant non-Hodgkin's lymphoma. Eur J Haematol. 2000 Mar;64(3):145-50. PMID: 10997879  PubMed
  2. The Clinical Diagnosis of Splenomegaly pubmedcentral.nih.gov  pdf 
  3. Splenomegaly  emedicine
 Also see Lymphatic System


About splenectomy

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About   MedlinePlus | ehendrick.org | ncbi.nlm.nih.gov  
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Movie  preop.medselfed.com 
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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.
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Splenectomy in Non-Hodgkin's lymphoma  ncbi.nlm.nih.gov/books

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.
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Splenectomy and risk of infection  lymphoma.org.uk
 
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.
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Value of FDG-PET in Prediction of Splenectomy Findings in Patients with Suspected or Known Lymphoma  ASH 2006 

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.
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The Leukemic Presentation of Mantle-cell Lymphoma: Disease Features and Prognostic Factors in 58 Patients. Leuk Lymphoma. 2004;45(10):2007-2015. PMID: 15370245 

 "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 patients."
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Surgical Indications in Idiopathic (unknown cause of) Splenomegaly archsurg.ama-assn.org  

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

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Laparoscopic Splenectomy for Malignant Hematologic Disease  ASCO 2000
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Splenectomy in patients with malignant non-Hodgkin's lymphoma.
Eur J Haematol. 2000 Mar;64(3):145-50. PMID: 10997879  PubMed | Related abstracts


Complications of splenectomy

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Postoperative complications after splenectomy for hematologic malignancies.
Ann Surg. 1996 Mar;223(3):290-6. PMID: 8604910  PubMed | Related abstracts

 

 
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