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Pathology of splenic lymphoma.

Eleven spleens removed surgically from patients with malignant lymphoma were compared according to gross, histologic, and cytologic appearances with spleens surgically removed from patients with nonmalignant disorders. The gross comparison indicates that the lymphomatous spleens were 10 to 20 times heavier than the nonmalignant spleens. The cut sectional surfaces revealed three types: (1) diffuse-homogeneous, (2) multinodular, (3) solitary and multinodular. Histologically they presented with a diffuse or nodular pattern. Splenic trabeculae and subendothelial spaces were markedly infiltrated by malignant cells. Sinusoidal congestion was prominent. Cytologically, five cases of splenic lymphomas were classified as well-differentiated lymphocytic lymphoma, five cases as poorly-differentiated lymphoma, and one case as composite lymphoma. Although numerous homogeneous lymphoid nodules were noted in the nodular lymphomas, no primary or secondary follicles or perifollicular marginal zones were seen in any of the cases of splenic lymphoma. In one spleen there were two cytologically distinct malignant lymphomas (composite lymphoma) consisting of a focal histiocytic lymphoma and a well-differentiated lymphocytic lymphoma. To our knowledge, this unusual association in the spleen has not been reported before. This experience suggests that the gross and microscopic alterations in primary splenic lymphoma can be differentiated from those seen in benign splenic disorders.