[Evaluation of the involvement of the spleen in Hodgkin's disease].

Abstract

In the light of personal data and 60 cases in the literature, the authors attempt to evaluate the risk of splenic involvement during Hodgkin's disease. Neither clinical examination nor scintiscanning of the spleen, permit one with sufficient security to recognise splenic involvement. Study of the context reveals, on the contrary, that the following factors contribute to the splenic risk: --Signs of evolutivity: their presence implies splenic involvement in 63% of cases; --the histological type of the frequency of the splenic involvement increases from type 1 (38%) to type 4 (61%); --the distribution of the lymph nodes above the diaphragm, the spleen is involved in 66% of forms with cervical and mediastinal and axillary lymph node involvement, 56% in forms with cervical and axillary nodes alone and 24% in forms with cervical and mediastinal nodes alone; --the data obtained by lymphography, as 89% of patients with lumboaortic gland involvement, also had invasion of the spleen. There may be errors of interpretation of lymphography, depending on the series, of from 6 to 25%. Thus, assessment of the risk of splenic involvement in Hodgkin's disease is carried out less on the splenic signs themselves, than on the clinical, laboratory, histological and radiological context.