CardioVascular and Interventional Radiology

, Volume 36, Issue 4, pp 1155–1160 | Cite as

Radioembolization of the Spleen: A Revisited Approach for the Treatment of Malignant Lymphomatous Splenomegaly

  • Kristoff Muylle
  • Jasmine Nguyen
  • Alexandre de Wind
  • Nathalie Meuleman
  • Philippe Delatte
  • Bruno Vanderlinden
  • Martine Roelandts
  • Anja Van der Stappen
  • Dominique Bron
  • Patrick Flamen
Case Report


Intraarterial administration of 90Y microspheres to the spleen in patients with malignant lymphoma was mentioned once in the literature in 1973. This case study illustrates the potential indication of selective internal radiotherapy in a heavily pretreated patient with highly refractory disease with a marginal zone lymphoma in leukemic phase and symptomatic splenomegaly. We describe the clinical course of disease; the biological and clinical response to the treatment after radioembolization; and simulation and dosimetry by multimodal imaging via single-photon emission computed tomography and computed tomography. The advantages of radioembolization for the management of lymphomatous splenomegaly are discussed.


Lymphoma Radioembolization Spleen Splenomegaly 



Conflict of interest

P. Flamen has been a consultant for Sirtex Medical for the last 3 years. The other authors declare that they have no conflict of interest


  1. 1.
    Kennedy A, Nag S, Salem R et al (2007) Recommendations for radioembolization of hepatic malignancies using yttrium-90 microsphere brachytherapy: a consensus panel report from the radioembolization brachytherapy oncology consortium. Int J Radiat Oncol Biol Phys 68:13–23PubMedCrossRefGoogle Scholar
  2. 2.
    Gates VL, Atassi B, Lewandowski RJ et al (2007) Radioembolization with yttrium-90 microspheres: review of an emerging treatment for liver tumors. Future Oncol 3:73–81PubMedCrossRefGoogle Scholar
  3. 3.
    Lewandowski RJ, Sato KT, Atassi B et al (2007) Radioembolization with yttrium-90 microspheres: angiographic and technical considerations. Cardiovasc Intervent Radiol 30:571–592PubMedCrossRefGoogle Scholar
  4. 4.
    Swerdlow SH, Campo E, Harris NL et al (eds) (2008) WHO classification of tumours of haematopoietic and lymphoid tissues, 4th edn. World Health Organization, GenevaGoogle Scholar
  5. 5.
    Bennett M, Schechter GP (2010) Treatment of splenic marginal zone lymphoma: splenectomy versus rituximab. Semin Hematol 47:143–147PubMedCrossRefGoogle Scholar
  6. 6.
    Brown JR, Friedberg JW, Feng Y et al (2009) A phase 2 study of concurrent fludarabine and rituximab for the treatment of marginal zone lymphomas. Br J Haematol 145:741–748PubMedCrossRefGoogle Scholar
  7. 7.
    Mohrbacher A (2005) B cell non-Hodgkin’s lymphoma: rituximab safety experience. Arthr Res Ther 7(Suppl 3):S19–S25CrossRefGoogle Scholar
  8. 8.
    Weber DA et al (1989) MIRD: radionuclide data and decay schemes. Society of Nuclear Medicine, New YorkGoogle Scholar
  9. 9.
    Ariel IM, Padula G (1973) Irradiation of the spleen by the intra-arterial administration of 90 yttrium microspheres in patients with malignant lymphoma. A preliminary rep Cancer 31:90–96Google Scholar
  10. 10.
    Becker CD, Rösler H, Biasiutti FD, Baer HU (1995) Congestive hypersplenism: treatment by means of radioembolization of the spleen with Y-90. Radiology 195:183–186PubMedGoogle Scholar
  11. 11.
    Kahl BS, Bartlett NL, Leonard JP et al (2010) Bendamustine is effective therapy in patients with rituximab-refractory, indolent B-cell non-Hodgkin lymphoma: results from a multicenter study. Cancer 116:106–114PubMedGoogle Scholar
  12. 12.
    Cullingford GL, Watkins DN, Watts AD, Mallon DF (1991) Severe late postsplenectomy infection. Br J Surg 78:716–721PubMedCrossRefGoogle Scholar
  13. 13.
    Maddison FE (1973) Embolic therapy of hypersplenism. Invest Radiol 8:280–281CrossRefGoogle Scholar
  14. 14.
    Spigos DG, Jonasson O, Mozes M, Capek V (1979) Partial splenic embolization in the treatment of hypersplenism. Am J Roentgenol 132:777–782CrossRefGoogle Scholar
  15. 15.
    Madoff DC, Denys A, Wallace MJ et al (2005) Splenic arterial interventions: anatomy, indications, technical considerations, and potential complications. Radiographics 25(Suppl 1):S191–S211PubMedCrossRefGoogle Scholar
  16. 16.
    Bilbao JI, de Martino A, de Luis E et al (2009) Biocompatibility, inflammatory response, and recannalization characteristics of nonradioactive resin microspheres: histological findings. Cardiovasc Intervent Radiol 32:727–736PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE) 2012

Authors and Affiliations

  • Kristoff Muylle
    • 1
    • 2
  • Jasmine Nguyen
    • 3
  • Alexandre de Wind
    • 4
  • Nathalie Meuleman
    • 3
  • Philippe Delatte
    • 5
  • Bruno Vanderlinden
    • 6
  • Martine Roelandts
    • 7
  • Anja Van der Stappen
    • 8
  • Dominique Bron
    • 3
  • Patrick Flamen
    • 1
  1. 1.Department of Nuclear MedicineJules Bordet Institute, ULBBrusselsBelgium
  2. 2.Faculty of MedicineVUBBrusselsBelgium
  3. 3.Department of HaematologyJules Bordet Institute, ULBBrusselsBelgium
  4. 4.Department of Anatomo-PathologyJules Bordet Institute, ULBBrusselsBelgium
  5. 5.Department of Interventional RadiologyUMC Sint-PieterBrusselsBelgium
  6. 6.Department of RadiophysicsJules Bordet Institute, ULBBrusselsBelgium
  7. 7.Department of RadiotherapyJules Bordet Institute, ULBBrusselsBelgium
  8. 8.Department of RadiologyJules Bordet Institute, ULBBrusselsBelgium

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