Sonographic examination showed spleen involvement in 43 patients with histological evidence of malignant lymphoma. In 23% of these cases the spleen was of normal size and 77% exhibited variable splenomegaly. Focal lesions could be seen in 27 patients, 16 exhibiting diffuse, small-nodule transformation of the sonographic parenchymal texture. Hodgkin lymphomas caused both focal (7 of 16) and diffuse (9 of 16), splenic lesions. All non-Hodgkin lymphomas of high-grade malignancy exhibited focal lesions, which are larger than 3 cm in diameter in 11 out of 13 patients. In non-Hodgkin lymphomas of low-grade malignancy, focal sites and diffuse destruction of splenic tissue texture were found, lesions of under 3 cm in diameter (11 of 13) being characteristic of this subtype. Indexing Words: Spleen involvement -Malignant lymphoma -Ultrasound In comparison to other parenchymatous organs, the spleen is rarely the site of tumor metastasis. Considered part of the lymphatic system, the spleen, however, is of great significance in staging procedures for malignant lymphoma. Imaging methods-particularly sonography-are employed in determining size, as the spleen cannot be satisfactorily examined by palpation on account of its protected site beneath the left costal arch. Spleen enlargement is a frequent finding in staging lymphoma. A normal-sized spleen, however, does not exclude the possibility of spleen involvement.' In Hodgkin lymphoma (HL) and non-Hodgkin-lymphomas of high-grade malignancy (NHL-hg) evidence of spleen involvement is of prognostic and therapeutic significance. The insufficient sensitivity of computed tomography and sonography in confirming abdominal involvement would justify the continuing use of operative staging in this type of lymphoma.'
While diffusely infiltrative alterations of the spleen were difficult to identify due to the fact that acoustically relevant structural differences from normal tissue were too small, newer, highresolution ultrasound equipment enables a bet-From the