title: Malignant splenic lymphoma: sonographic patterns, diagnosis and follow-up.
abstract: Six hundred and eighty patients with malignant lymphoma were studied by abdominal sonography during 1983 and 1993 at our institution. Abnormal splenic texture was noted in 101 patients (14,8%). Involvement of the spleen was confirmed histologically (n = 8), by sonographic follow-up (n = 82), and on the basis of the clinical course in the remaining patients. Of the 101 patients with splenic involvement, 34 had Hodgkin's disease, 38 had a low-grade non-Hodgkin's lymphoma and 29 a high-grade non-Hodgkin's lymphoma. Four different sonographic patterns were observed: (1) Diffuse involvement in 37 patients (pts) (36.6%). (2) Focal small nodular lesions in 39 pts (38.6%). (3) Focal large nodular lesions in 23 pts (22,7%). (4) 'Bulky, disease' in two pts (1.9%). All of the high-grade lymphomas showed either large nodular (15/29) or small nodular (14/29) lesions. The diffuse or small nodular pattern was seen predominantly in low-grade lymphomas (35/38) and in Hodgkin's disease (31/34).
  
  
  CONCLUSIONS
  A number of different patterns of splenic involvement in lymphoma can be demonstrated by ultrasound. Splenic sonographic patterns can be linked to histological lymphoma entities.
authors.affiliation: Department of Internal Medicine, Philipps-University, Marburg, Germany.
authors.forename: C
authors.initials: C
authors.lastname: Gorg
authors.forename: R
authors.initials: R
authors.lastname: Weide
authors.forename: W B
authors.initials: WB
authors.lastname: Schwerk
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003937:Diagnosis, Differential; D005260:Female; D005500:Follow-Up Studies; D006689:Hodgkin Disease / Q000000981:diagnostic imaging*; D006801:Humans; D008228:Lymphoma, Non-Hodgkin / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D013154:Spleen / Q000473:pathology; D013160:Splenic Neoplasms / Q000000981:diagnostic imaging*; D014463:Ultrasonography