Abdominal lymphoma: lack of complete surgical staging

At present there is no consensus on the optimal management of patients with abdominal lymphomas. One major obstacle in treatment planning is the lack of adequate surgical staging. A retrospective review of 33 consecutive patients presenting with abdominal lymphoma revealed that the initial surgical procedures were deficient in most cases. Frequent omissions were failure to biopsy the regional lymph nodes and liver, lack of splenectomy, and lack of adequate description of the spleen. Until prospective studies of various treatment regimens can be carried out in adequately surgically staged patients with abdominal lymphomas, no clear treatment recommendations can be made. Surgical staging should include description, biopsy, and (if possible) resection of the primary tumour; description and biopsy of involved and regional lymph nodes; biopsy of the liver; description of and (if possible) resection of the spleen; and bone marrow.