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Clinicopathological features of primary splenic follicular lymphoma

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Abstract

Follicular lymphoma (FL) is a low-grade lymphoma that is usually characterized by generalized lymphadenopathy. Extranodal invasion by FL generally involves the bone marrow, skin, and duodenum; splenic infiltration often occurs in the advanced stages. However, primary splenic FL is very rare. Hence, few studies have been performed on splenic FL, and its clinicopathological features have not been established. This study aimed to investigate the clinicopathological features of primary splenic FL, as compared to nodal FL. We analyzed 17 patients diagnosed with primary splenic FL and 153 control patients with systemic FL. Hepatitis C virus (HCV)-positive status was significantly more common in patients with splenic FL than in the control patients (p = 0.02). Ann Arbor stage III or IV (p = 0.0003) and high-risk FLIPI (Follicular Lymphoma International Prognostic Index) (p = 0.03) were significantly less common in patients with splenic FL than in the control patients; however, the overall and progression-free survival curves were not significantly different between the groups. Among the 17 patients with splenic FL, the progression-free survival was significantly worse in patients who underwent splenectomy without receiving postoperative chemotherapy than in those who did (p = 0.03). These results suggest that primary splenic FL should be considered different from systemic FL; accordingly, its management should also be conducted differently.

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Authors and Affiliations

  1. Department of Pathology, School of Medicine, Kurume University, 67, Asahi-machi, Kurume, 830-0011, Japan

    Joji Shimono, Hiroaki Miyoshi, Yuya Sasaki, Daisuke Kurita, Keisuke Kawamoto, Masao Seto & Koichi Ohshima

  2. Department of Hematology, Hokkaido University Graduate School of Medicine, Sapporo, Japan

    Joji Shimono & Takanori Teshima

  3. Department of Hematology, Hara Sanshin Hospital, Fukuoka, Japan

    Tomohiko Kamimura

  4. Department of Hematology, Hamanomachi Hospital, Fukuoka, Japan

    Tetsuya Eto

  5. Department of Hematology, Kushiro Rosai Hospital, Kushiro, Japan

    Takuto Miyagishima

  6. Department of Hematology, School of Medicine, Kurume University, Kurume, Japan

    Koji Nagafuji

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  1. Joji Shimono
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Correspondence to Hiroaki Miyoshi.

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Electronic supplementary material

Supplementary Fig. 1

Differences in overall survival (a) and progression-free survival (b) between patients with splenic follicular lymphoma (FL) (n = 17) and nodal FL (n = 153). The overall survival and progression-free survival curves did not significantly differ between patients with splenic vs. nodal FL (p = 0.69 and 0.24, respectively). (GIF 69 kb)

High Resolution Image (TIFF 451 kb)

Supplementary Fig. 2

Overall survival (a) and progression-free survival (b) in the 17 patients with splenic follicular lymphoma (FL) according to the diagnosis of Type A (n = 12) or Type B (n = 5) splenic FL. The overall survival and progression-free survival curves did not significantly differ between patients with Type A vs. B splenic FL (p = 0.34 and 0.43, respectively). (GIF 52 kb)

High Resolution Image (TIFF 365 kb)

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Shimono, J., Miyoshi, H., Kamimura, T. et al. Clinicopathological features of primary splenic follicular lymphoma. Ann Hematol 96, 2063–2070 (2017). https://doi.org/10.1007/s00277-017-3139-y

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