Skip to main content
SpringerLink
Log in

Accuracy of Laparoscopy in the Diagnosis and Staging of Lymphoproliferative Diseases

  • Original Scientific Reports
  • Published:
World Journal of Surgery Aims and scope Submit manuscript

Abstract

Laparoscopy seems to be playing an emerging role in the management of lymphoproliferative diseases. The aim of this study was to prospectively analyze personal experience evaluating the role and limits of laparoscopy in the management of lymphomas. From July 1993 to December 2000, 131 consecutive patients were referred to our institution for primary diagnosis (group A, n = 70), suspected relapse (reassessment) (group B, n = 54), or staging/restaging of lymphoproliferative diseases (group C, n = 7). Diagnostic and/or operative laparoscopy was performed in all patients. To assess the accuracy of laparoscopy, the results were analyzed according to the indications for surgery. In all, 128 procedures were completed laparoscopically (95.5%). Conversion was required in 7 cases (5.1%). Causes of the conversions were severe obesity (body mass index 62.5), uncontrolled intraoperative bleeding (HIV+), nondiagnostic tissue sampling (2 cases), perisplenic inflammation and perisplenic abscesses (3 cases). The results of this study highlight the safety of diagnostic and staging laparoscopy and laparoscopic splenectomy in patients with lymphoproliferative diseases (major complications 2.9%, perioperative mortality 0%). In all, 96.4% of patients from group A and 100% of patients from group B were treated on the basis of laparoscopic findings. No false negative diagnosis occurred. Laparoscopy may become the “gold standard” in the management of lymphoproliferative disease in the following settings: for the differential diagnosis of hepatic and/or splenic focal lesions; when percutaneous needle biopsy fails and/or genetic analysis is needed for therapeutic decision; for the primary diagnosis and abdominal staging of patients with diffuse retroperitoneal lymphadenopathy in the absence of peripheral lymphadenopathy; for cases of abdominal restaging after concurrent chemoradiotherapy and in cases of suspected relapse when percutaneous biopsy is not technically possible; and for patients with lymphoproliferative disease when splenectomy is required. Marked splenomegaly with perisplenic inflammatory reaction and lymphadenopathy in HIV+ patients should be considered possible causes of failure of the laparoscopic approach.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1.

Similar content being viewed by others

References

  1. E Glatstein JM Guernsey SA Rosenberg et al. (1969) ArticleTitleThe value of laparotomy and splenectomy in the staging of Hodgkin’s disease Cancer 24 709–718 Occurrence Handle1:STN:280:CCaB1MjhsFI%3D Occurrence Handle4980685

    CAS  PubMed  Google Scholar 

  2. JP Glees LC Barr TJ McElwan et al. (1982) ArticleTitleThe changing role of staging laparotomy in Hodgkin’s disease: a personal series of 310 patients Br. J. Surg. 69 181–187 Occurrence Handle1:STN:280:Bi2C1czjvFc%3D Occurrence Handle7074311

    CAS  PubMed  Google Scholar 

  3. SF Williams HM Golomb (1986) ArticleTitlePerspective on staging approaches in the malignant lymphomas Surg. Gynecol. Obstet. 163 193–201 Occurrence Handle1:STN:280:BimB1cboslc%3D Occurrence Handle3526595

    CAS  PubMed  Google Scholar 

  4. K Fox D Silfen A Alavi (1991) ArticleTitleApplications of gallium-67 scintigraphy in the management of patients with malignant lymphoma J. Nucl. Med. 32 2299–2305 Occurrence Handle1:STN:280:By2D2sbgslc%3D Occurrence Handle1720816

    CAS  PubMed  Google Scholar 

  5. O Cohen-Haguenauer P Brice M Gaci et al. (1993) ArticleTitleGallium-67 scintigraphy in lymphomas Presse Med. 22 521–525 Occurrence Handle1:STN:280:ByyB1cflvFI%3D Occurrence Handle8511078

    CAS  PubMed  Google Scholar 

  6. SP Strijk (1987) ArticleTitleLymphography and abdominal computed tomography in the staging of non-Hodgkin lymphoma Acta Radiol. 28 263–269 Occurrence Handle1:STN:280:BieD3c%2Fis1Q%3D Occurrence Handle2958031

    CAS  PubMed  Google Scholar 

  7. BR Hoane AF Shields BA Porter et al. (1994) ArticleTitleComparison of initial lymphoma staging using computed tomography and magnetic resonance imaging Am. J. Hematol. 47 100–105 Occurrence Handle1:STN:280:ByuA2sbgtFU%3D Occurrence Handle8092123

    CAS  PubMed  Google Scholar 

  8. WG Negendank AM Al-Katib C Karanes et al. (1990) ArticleTitleLymphomas: MR imaging contrast characteristics with clinical-pathologic correlations Radiology 177 209–216 Occurrence Handle1:STN:280:By%2BA2sfgslI%3D Occurrence Handle2399318

    CAS  PubMed  Google Scholar 

  9. JR Skillings V Bramweel RL Nicholson et al. (1991) ArticleTitleA prospective study of magnetic resonance imaging in lymphoma staging Cancer 67 1838–1843 Occurrence Handle1:STN:280:By6C28fgs1Y%3D Occurrence Handle2004296

    CAS  PubMed  Google Scholar 

  10. BC Erwin RK Brynes WC Chan et al. (1986) ArticleTitlePercutaneous needle biopsy in the diagnosis and classification of lymphoma Cancer 57 1074–1078 Occurrence Handle1:STN:280:BimC3crntFM%3D Occurrence Handle3943023

    CAS  PubMed  Google Scholar 

  11. RA Castellino RT Hoppe N Blank et al. (1984) ArticleTitleComputed tomography, lymphography and staging laparotomy: correlation in initial staging of Hodgkin’s disease Am. J. Roentgenol. 143 37–41 Occurrence Handle1:STN:280:BiuB38fgsFY%3D

    CAS  Google Scholar 

  12. T Suzuky H Shibuya S Yoshimatsu et al. (1987) ArticleTitleUltrasonically guided staging splenic tissue core biopsy in patients with non-Hodgkin lymphoma Cancer 60 879–882 Occurrence Handle3297301

    PubMed  Google Scholar 

  13. M Jockovich NP Mendenhall MD Sombeck et al. (1994) ArticleTitleLong-term complications of laparotomy in Hodgkin’s disease Ann. Surg. 6 615–624

    Google Scholar 

  14. BJ Bain (1995) ArticleTitleRoutine and specialised techniques in the diagnosis of haematological neoplasms J. Clin. Pathol. 48 501–508 Occurrence Handle1:STN:280:ByqA1MrgsFY%3D Occurrence Handle7665691

    CAS  PubMed  Google Scholar 

  15. SI Schwartz (1996) ArticleTitleRole of splenectomy in hematological disorders World J. Surg. 20 1056–1059 Occurrence Handle10.1007/s002689900176

    Article  Google Scholar 

  16. BA Salky JJ Bauer IM Gerlerent et al. (1988) ArticleTitleThe use of laparoscopy in retroperitoneal pathology Gastrointest. Endosc. 34 227–230 Occurrence Handle1:STN:280:BieB2s7ovFA%3D Occurrence Handle2968939

    CAS  PubMed  Google Scholar 

  17. M Rhodes M Rudd N O’Rourke et al. (1995) ArticleTitleLaparoscopic splenectomy and lymph node biopsy for haematological disorders Ann. Surg. 222 43–46 Occurrence Handle1:STN:280:ByqA2cvislI%3D Occurrence Handle7618967

    CAS  PubMed  Google Scholar 

  18. K Conlon A Zelentez M Quaglia ParticleLa et al. (1996) ArticleTitleLaparoscopy: redefining the role of the surgeon in abdominal lymphoma Surg. Endosc. 8 S10

    Google Scholar 

  19. BG Mann KC Conlon M Laquaglia et al. (1998) ArticleTitleEmerging role of laparoscopy in the diagnosis of lymphoma J. Clin. Oncol. 16 1909–1915 Occurrence Handle1:STN:280:DyaK1c3ks1ehsw%3D%3D Occurrence Handle9586909

    CAS  PubMed  Google Scholar 

  20. G Terrosu A Donini F Silvestri et al. (1996) ArticleTitleLaparoscopic splenectomy in the management of hematological diseases Surg. Endosc. 10 441–444 Occurrence Handle10.1007/s004649910087 Occurrence Handle1:STN:280:BymB28rpsVE%3D Occurrence Handle8661800

    Article  CAS  PubMed  Google Scholar 

  21. G Silecchia A Fantini L Raparelli et al. (1999) ArticleTitleManagement of abdominal lymphoproliferative diseases in the era of laparoscopy Am. J. Surg. 177 325–330 Occurrence Handle10.1016/S0002-9610(99)00056-2 Occurrence Handle1:STN:280:DyaK1M3ls1Ortw%3D%3D Occurrence Handle10326853

    Article  CAS  PubMed  Google Scholar 

  22. B Delaitre B Maignien (1991) ArticleTitleSplenectomy by the coelioscopic approach. Report of a case Presse Med. 20 2263 Occurrence Handle1:STN:280:By2C2c7htVE%3D

    CAS  Google Scholar 

  23. EC Poulin C Thibault J Mamazza (1995) ArticleTitleLaparoscopic splenectomy Surg. Endosc. 9 172–176 Occurrence Handle1:STN:280:ByqA38%2FnsVw%3D Occurrence Handle7597588

    CAS  PubMed  Google Scholar 

  24. GG Tsiotos RT Schinkert (1997) ArticleTitleLaparoscopic splenectomy for immune thrombocytopenic purpora Arch. Surg. 132 642–646 Occurrence Handle1:STN:280:ByiA2c7ltlQ%3D Occurrence Handle9197857

    CAS  PubMed  Google Scholar 

  25. BJ Bain (1995) ArticleTitleRoutine and specialised techniques in the diagnosis of haematological neoplasms J. Clin. Pathol. 48 501–508 Occurrence Handle1:STN:280:ByqA1MrgsFY%3D Occurrence Handle7665691

    CAS  PubMed  Google Scholar 

  26. InstitutionalAuthorNameGeneral Haematology Task Force of BCSH (1994) ArticleTitleImmunophenotyping in the diagnosis of chronic lymphoproliferative disorders J. Clin. Pathol. 47 971–975

    Google Scholar 

  27. BL Steel MR Schwartz I Ramzy (1994) ArticleTitleFine needle aspiration biopsy in the diagnosis of lymphadenopathy in 1103 patients Acta Cytol. 38 76–81

    Google Scholar 

  28. D Ben-Yehuda A Polliack E Okan et al. (1996) ArticleTitleImage-guided core-needle biopsy in malignant lymphoma: experience with 100 patients that suggest the technique is reliable J. Clin. Oncol. 14 2431–2434 Occurrence Handle1:STN:280:ByiD3MrgsFQ%3D Occurrence Handle8926505

    CAS  PubMed  Google Scholar 

  29. N Harris E Jaffe H Stain et al. (1994) ArticleTitleA revised European–American classification of lymphoid neoplasm: a proposal from the International Lymphoma Study Group Blood 84 1361–1392 Occurrence Handle1:STN:280:ByuA2cfgsFM%3D Occurrence Handle8068936

    CAS  PubMed  Google Scholar 

  30. RA Cowels A Yahanda (2000) ArticleTitleLaparoscopic biopsy of abdominal retroperitoneal lymphadenopathy for the diagnosis of lymphoma J. Am. Coll. Surg. 191 108–113 Occurrence Handle10.1016/S1072-7515(00)00279-9 Occurrence Handle10898191

    Article  PubMed  Google Scholar 

  31. RJ Biggard C Rabkin (1996) ArticleTitleThe epidemiology of AIDS-related neoplasm Hematol. Oncol. Clin. North Am. 10 997–1010 Occurrence Handle8880192

    PubMed  Google Scholar 

  32. AM Levine (1996) ArticleTitleHIV-associated Hodgkin’s disease: biological and clinical aspects Hematol. Oncol. Clin. North Am. 10 1135–1148 Occurrence Handle1:STN:280:ByiD3svlsVE%3D Occurrence Handle8880201

    CAS  PubMed  Google Scholar 

  33. AS Sandler L Kaplan (1996) ArticleTitleDiagnosis and management of systemic non-Hodgkin’s lymphoma in HIV disease Hematol. Oncol. Clin. North Am. 10 1111–1124 Occurrence Handle1:STN:280:ByiD3svlsVc%3D Occurrence Handle8880199

    CAS  PubMed  Google Scholar 

  34. D Serraino P Pezzotti M Dorucci et al. (1997) ArticleTitleCancer incidence in a cohort of human immunodeficiency virus seroconverts Cancer 79 1004–1008 Occurrence Handle10.1002/(SICI)1097-0142(19970301)79:5<1004::AID-CNCR17>3.0.CO;2-5 Occurrence Handle1:STN:280:ByiC1Mzlslw%3D Occurrence Handle9041163

    Article  CAS  PubMed  Google Scholar 

  35. U Tirelli M Spina E Vaccher et al. (1995) ArticleTitleClinical evaluation of 451 patients with HIV-related non-Hodgkin’s lymphoma: experience of the Italian Cooperative Group on AIDS and Tumour (GICAT) Leukaemia Lymphoma 20 91–96 Occurrence Handle1:STN:280:BymA2M7pslc%3D

    CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Surgery, “Paride Stefanini,” Policlinico Umberto I, University “La Sapienza”, Viale del Policlinico, 155, 00161, Rome, Italy

    Gianfranco Silecchia M.D., Luigi Raparelli M.D., Nicola Perrotta M.D., Aldo Fantini M.D., Paolo Fabiano M.D. & Nicola Basso M.D.

  2. Department of Hematology, Policlinico Umberto I, University “La Sapienza”, Viale del Policlinico, 155, 00161, Rome, Italy

    Bruno Monarca M.D.

Authors
  1. Gianfranco Silecchia M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Luigi Raparelli M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Nicola Perrotta M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Aldo Fantini M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Paolo Fabiano M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Bruno Monarca M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Nicola Basso M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Silecchia, G., Raparelli, L., Perrotta, N. et al. Accuracy of Laparoscopy in the Diagnosis and Staging of Lymphoproliferative Diseases. World J. Surg. 27, 653–658 (2003). https://doi.org/10.1007/s00268-003-6692-6

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00268-003-6692-6

Keywords

Search

Navigation