A Case of Primary Hodgkin's Disease of the Spleen

Naomi Kawata, Masao Hayashi, Akifumi Miyoshi, Takashi Funatsu*, Shingo Saito**, Yoshikazu Suzuki**, Nobuaki Kobayashi**

Department of Surgery and *Internal Medicine, Tsushima Municipal Hospital
**First Department of Surgery, Ehime University School of Medicine

A 72-year-old man consulted our hospital complaining of subfever, weight loss and left hypochondralgia. The superficial lymph nodes and spleen were not palpable. Abdominal echography and computed tomography revealed a tumor in the spleen which was detected by gallium scintigraphy as a strong accumulation. We operated on him under a diagnosis of suspected malignant lymphoma. The tumor of the spleen extended to the tail of the pancreas, and No. 10, 11, 18 lymph nodes were swollen. Total splenectomy with partial pancreatectomy and lymph node cleaning was achieved. The resected tumor was elastic hard, measured 15×12×12 cm in size, and was solid, white-yellow, and well-defined. The histological diagnosis was Hodgkin's disease, mixed cellularity which invaded the pancreas, and metastases of No. 10, 11, 18 lymph nodes. Six courses of postoperative chemotherapy with cyclophosphamide, vincristine, procarbazine and predonizolone were given. He is well and asymptomatic in a follow-up period of 3 years 6 months. Most cases of Hodgkin's disease occur from superificial lymph nodes. This is a very rare case of primary Hodgkin's disease of the spleen.

Key words
primary malignant lymphoma of the spleen, primary Hodgkin's disease of the spleen

Reprint requests
Naomi Kamata Department of Surgery, Tsushima Municipal Hospital
Takata, Tsushima-cho, Kitauwa-gun, Ehime, 798-33 JAPAN

Accepted
July 5, 1995

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