Key Points in the Management of Splenic Lymphomas Presenting as Splenomegaly
- Multiple subtypes of lymphoma can present as isolated splenomegaly, but treatment remains specific to histology.
- Analysis of peripheral blood and marrow should be undertaken to establish the diagnosis.
- In cases where tissue diagnosis must be made from the spleen, we favor splenectomy, given the simultaneous benefit of establishing the diagnosis and providing effective therapy.
- Single-agent rituximab is uniquely active in splenic marginal zone lymphoma and can be used in lieu of splenectomy in some cases, particularly in patients who are poor surgical candidates or patients with significant disease burden outside the spleen.