Xiros N, Economopoulos T, Christodoulidis C, Dervenoulas J, Papageorgiou E, Mellou S, Styloyiannis S, Tsirigotis P, Raptis S A
Second Department of Internal Medicine-Propaedeutic, Evangelismos Hospital, University of Athens, Greece.
Eur J Haematol. 2000 Mar;64(3):145-50. doi: 10.1034/j.1600-0609.2000.90079.x.
Splenectomy in patients with non-Hodgkin's lymphoma (NHL) is performed for either diagnostic or therapeutic reasons. We report on a series of 29 patients with NHL and splenomegaly who underwent splenectomy during the years 1979-1998 in our hospital. According to the indication for splenectomy our patients were categorized in three groups. Group A: In 20 patients splenectomy was performed for diagnostic reasons. Group B: Three patients were splenectomized for autoimmune haemolytic anaemia (AIHA). Group C: Six patients underwent splenectomy because of hypersplenism. A definitive histopathological diagnosis of NHL was obtained in all patients of group A. Hypersplenism and AIHA were resolved in all patients after splenectomy. One (3.5%) patient died postoperatively because of septicemia complicated by disseminated intravascular coagulation. Six postoperative complications were observed in 4 (14%) patients. Splenectomy, with an acceptable surgical risk, has the potential to establish the diagnosis of NHL in patients with splenomegaly without lymphadenopathy and negative bone marrow findings. Moreover, splenectomy has the capacity to modify the disease course in patients with NHL complicated by AIHA or hypersplenism.
非霍奇金淋巴瘤（NHL）患者行脾切除术，目的是诊断或治疗。我们报告了1979年至1998年期间在我院接受脾切除术的29例NHL合并脾肿大患者。根据脾切除术的指征，我们将患者分为三组。A组：20例患者因诊断目的行脾切除术。B组：3例患者因自身免疫性溶血性贫血（AIHA）行脾切除术。C组：6例患者因脾功能亢进行脾切除术。A组所有患者均获得了NHL的确切组织病理学诊断。脾切除术后所有患者的脾功能亢进和AIHA均得到缓解。1例（3.5%）患者术后因败血症并发弥散性血管内凝血死亡。4例（14%）患者出现6例术后并发症。脾切除术具有可接受 的手术风险，对于无淋巴结病且骨髓检查结果阴性的脾肿大患者，有潜力确立NHL的诊断。此外，脾切除术有能力改变合并AIHA或脾功能亢进的NHL患者的病程。
