Splenectomy in patients with malignant non-Hodgkin's lymphoma

Splenectomy in patients with non-Hodgkin's lymphoma (NHL) is performed for either diagnostic or therapeutic reasons. We report on a series of 29 patie nts with NHL and splenomegaly who underwent splenectomy during the years 19 79-1998 in our hospital. According to the indication for splenectomy our pa tients were categorized in three groups. Group A: In 20 patients splenectom y was performed for diagnostic reasons. Group B: Three patients were splene ctomized for autoimmune haemolytic anaemia (AIHA). Group C: Six patients un derwent splenectomy because of hypersplenism. A definitive histopathologica l diagnosis of NHL was obtained in all patients of group A. Hypersplenism a nd AIHA were resolved in all patients after splenectomy. One (3.5%) patient died postoperatively because of septicemia complicated by disseminated int ravascular coagulation. Six postoperative complications were observed in 4 (14%) patients. Splenectomy, with an acceptable surgical risk, has the pote ntial to establish the diagnosis of NHL in patients with splenomegaly witho ut lymphadenopathy and negative bone marrow findings. Moreover, splenectomy has the capacity to modify the disease course in patients with NHL complic ated by AIHA or hypersplenism.