Splenic Lymphoma: Causes, Symptoms, Treatment, Prognosis

Splenic lymphoma or splenic marginal zone lymphoma is a rare kind of cancer of spleen and bone marrow. There are two kinds of lymphomas, non-Hodgkin lymphoma and Hodgkin lymphoma; and Splenic lymphoma is B-cell non-Hodgkin lymphoma.

The spleen is located on the left side of abdomen in the human body. It is the primary organ of the immune system. Lymphoma is the cancer of lymphocytes, which occurs when the lymphocytes multiply uncontrollably. Lymphocytes are the kind of white blood cells which help the body to fight any form of infection. A type of fluid called lymph that flows through the lymphatic system carries these cells. There are two primary kinds of Lymphocytes, namely B-lymphocytes and T-lymphocytes. B-cell lymphocytes are present in the margin of the spleen and other lymphoid tissue. Splenic lymphoma is basically B-cell lymphoma.

Splenic lymphoma is a rare form of cancer. This condition generally develops in people aged over 60 years, and affects males more than females. No specific cause for development of splenic lymphoma has yet been identified. People suffering from diseases like Epstein-Barr virus infection, Hepatitis C, malaria, Helicobacter pylori (H. pylori), Waldenstrom’s macroglobulinemia, autoimmune diseases like HIV, systemic lupus, Sjogren’s syndrome, erythematosus, etc. are more likely to develop splenic lymphoma. Further, factors like smoking, some genetic disorders like Down syndrome, exposure to environmental toxins, pesticides and hazardous chemicals like benzene, exposure to radiation and chemotherapy, and a family history of this disease, are known to increase an individual’s risk of developing splenic lymphoma. Also, other cancers like lung cancer, breast cancer and melanoma, can spread to the spleen and cause spleen lymphoma.

Most patients suffering from splenic lymphoma are found to be asymptomatic, i.e., they do not show any symptoms of the disease. However, in certain cases the condition is found accidentally by the doctor while examining the patient’s abdomen for some other reason. A visibly enlarged spleen is noticed during the examination which in medical terminology is known as splenomegaly.

If the patient suffering from splenic lymphoma has an extremely enlarged or over-sized spleen, they tend to complain of constant abdominal pain and discomfort. Symptoms of Splenic lymphoma, if present, include anemia which leads to extreme fatigue and breathlessness. Splenic lymphoma is also characterized by a fall in the platelet count, which results in easy bruising and bleeding from cracks and fissures in the body. Other signs of splenic lymphoma are frequent infections, back pain, low blood pressure, abnormal weight loss, itching and swelling in the legs.

Blood tests, bone marrow test, imaging tests like MRI, PET or CT scan of the abdomen, ultrasound and even biopsy of a lymph node may need to be conducted to diagnose splenic lymphoma. Once the splenic lymphoma is detected, treatment is determined based on whether the symptoms are problem causing or not. Treatment of splenic lymphoma also depends on the general health of the patient. Majority cases of splenic lymphoma do not manifest any symptoms. If the patient does not experience any symptoms, then the doctor would choose to just monitor the patient and stick to wait and watch approach. Only when symptoms develop, the doctor would start with a suitable treatment. In case of patients with an underlying problem like hepatitis C, the lymphoma can be cleared off simply by treating the specific underlying condition and no further therapy would be needed in such a situation.

Treatment for splenic lymphoma is only required by patients if their symptoms are problematic or their blood count is persistently low. In such cases, surgical removal of the spleen is considered to be the best form of treatment for splenic lymphoma. This spleen removal surgery is called splenectomy. It is only performed if the patient is judged fit for the operation. Otherwise, alternative treatments like radiotherapy, chemotherapy or antibody therapy are used for the purpose.

If diagnosed in its early stage and treated properly, the prognosis for a patient of spleen lymphoma is highly positive. In case of a relapse, the patient may need to undergo chemotherapy to treat the disease and prevent any further recurrences.