Clinicopathological Characteristics And Survival Analysis Of Primary Lymphoma Of The Spleen

ObjectiveTo retrospectively analyze the clinicopathological characteristics and surgical method of primary lymphoma of the spleen(PLS), and to discuss the relationship between clinical indicators and prognosis.MethodsWe collected the clinical data of31patients with PLS confirmed by postsurgical pathology from October2006to October2012at Shandong University Qilu hospital, including general information, blood、imaging data and pathological characteristics.Then SPSS19.0was used for survival analysis according to the outcome of our follow-up surveys,and relationship between clinical indicators and prognosis was analyzed using log-rank single factor and Cox multivariate model.Results1.Of the31PLS patients,22were male, and9were female,with the ratio of2.4:1; The average age was53.3, the median age was49(15to77), and12were more than60years old.2.28cases had a history of splenomegaly, and the median history was2months ranged from1to5;The clinical manifestations included pyrexia(12/31), left upper quadrant pain,anorexia(26/31),weight-loss (19/31);Physical examination suggested mild splenomegaly in9cases, moderate splenomegaly in16cases and6cases with severe splenomegaly.3.Blood test showed that the value of WBC、RBCand PLT all droped in8 cases, and another12cases had one kind or two kinds of blood cell decrease.Ultrasound revealed that there were one or several solid masses with low echo area,or a diffuse enlargement of the spleen. CT indicated low-desity masses in spleen or diffuse splenomegaly,19cases had splenic hilar lymph nodes enlargement and2with hepatomegaly.4.According to Ahmann staging,7cases in stage Ⅰ received splenectomy;19cases in stage Ⅱ had splenectomy and splenic hilar lymph nodes dissection;The5stage Ⅲ cases underwent palliative operation in stage Ⅲ.5. All the31cases were NHL and29were B cell NHL,including SMZL(12/29),FL(1/29).DLBCL(16/19),and the left2cases were T cell NHL.Of the31cases,13were Idolent lymphoma and18were invasive lymphoma.6.The median survival period was69months and the cumulative1-,3-, and5-year survival rates were63.6%,36.4%, and30.3%, respectively. Log-rank test and Cox model multivariate analysis showed that the survival time was closly related to age and immunophenotyping.Conclusion1.PLS are mainly NHL and mostly derive from B lymphocyte, having a male and ageness dominance in this analysis.2.To the patients with splenomegaly, pyrexia,left upper quadrant pain,anorexia,weight-loss emerged recently,blood cell level dropped and abnormal masses with low density or signal appeared in spleen in CT or Ultrasound,we should highly suspect the generation of PLS.3.Curative tumor resection plus postsurgical chemothrapy is known to be the most effective therapeutic measure to PLS.4.Age and histological immunophenotype were independent prognostic risk factors.old age(>60) and invasive lymphoma predicate poor survival.