Lymphomas of the spleen and bone marrow lymphoid nodules

Many nodular primitive non-Hodgkin's lymphomas of the spleen have a favourable course after splenectomy or chemotherapy. Several observations of this type have been reported in the literature, in which the concept of malignancy is discussed, authors referring to a presarcomatous state or to an idiopathic splenomegaly. The evaluation of the extension of those sarcomas, however, very often show hepatic lesions, and always an increase in the lymphoid marrow nodules. The significance of these nodules is discussed here, with reference to 14 personal observations. These nodules may not always reflect a real extension of the sarcoma to the marrow. From a practical point of view, the presence of lymphoid marrow nodules, when associated with an isolated splenomegaly, is a strong argument to suspect a sarcoma of the spleen, and indicates a splenectomy.