Analysis of clinical and ultrasonographic features between splenic lymphoma and splenic metastases

doi:10.3877/cma.j.issn.1672-6448.2022.05.008

Abstract

Abstract:

Objective

To improve the ability of ultrasonic differential diagnosis by analyzing the clinical manifestations and ultrasonographic characteristics of splenic lymphoma and splenic metastases.

Methods

The clinical and ultrasonographic data of 50 patients with splenic lymphoma and 15 patients with splenic metastases diagnosed by pathology at West China Hospital of Sichuan University from January 2004 to April 2021 were analyzed retrospectively. The t-test and χ² test or Fisher's exact test were used to compare the differences of clinical manifestations and conventional ultrasonographic characteristics between the two groups.

Results

Patients with splenic metastases usually had a history of primary malignant tumors in other parts compared to those with splenic lymphoma (40.0% vs 0), which was significantly different (P＜0.001). No significant difference was observed in age, sex, fever, night sweats, weight loss, or abdominal pain between the two groups (P＞0.05). In terms of morphological classification, lesion echo, splenomegaly, and number of lesions: the proportions of diffuse lesions, lesions with solid echo, and patients with splenomegaly were higher in splenic lymphoma than in splenic metastases (44.0% vs 0; 89.3% vs 60.0%; 76.0% vs 20.0%), and the lesions of splenic metastases were mostly single (86.7% vs 50.0%); the differences were statistically significant (χ²=17.409, P＜0.001; χ²=5.047, P=0.046; χ²=15.537, P＜0.001; P=0.023). There were no significant differences between splenic lymphoma and splenic metastases in terms of boundaries, morphology, blood flow signal, and abdominal cavity and retroperitoneal lymph node growth (P＞0.05). The comparison of the maximum diameter of the lesions [(5.31±2.56) cm vs (6.23±3.55) cm] was also not statistically significant (P＞0.05).

Conclusion

Although there are similarities between the clinical and ultrasonographic characteristics of splenic lymphoma and splenic metastases, patients with splenic metastases often have a history of primary tumors, which morphologically manifest as single lesions with larger diameters, and splenomegaly is uncommon. In contrast, splenic lymphoma can have a variety of morphological types, diffuse and mixed lesions are more common, and unlike splenic metastases, lesion echoes of splenic lymphoma are more likely to manifest as solid echoes with splenomegaly.

Key words: Splenic lymphoma, Splenic metastases, Spleen, Ultrasound

Lacong Geiru, Jieying Zhao, Jingwen Yan, Hua Zhuang. Analysis of clinical and ultrasonographic features between splenic lymphoma and splenic metastases[J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2022, 19(05): 434-439.

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URL: https://chaosheng.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1672-6448.2022.05.008

https://chaosheng.cma-cmc.com.cn/EN/Y2022/V19/I05/434

Figures/Tables 2

项目	淋巴瘤（n=50）	转移癌（n=15）	统计值	P值
年龄（岁， $x ¯$ ±s）	57.36±12.98	56.80±13.49	t=0.145	0.885
性别［例（%）］			χ²=1.117	0.374
男	31（62.0）	7（46.7）
女	19（38.0）	8（53.3）
临床症状（例）
发热	4	0	-	0.566
盗汗	0	0	-	-
体质量下降	6	1	χ²=0.012	0.913
腹痛	13	5	χ²=0.052	0.820
体检发现	8	6	χ²=2.641	0.104
原发恶性肿瘤病史［例（%）］			-	＜0.001
有	0（0）	6（40.0）
无	50（100）	9（60.0）

项目	淋巴瘤（n=50）	转移癌（n=15）	统计值	P值
年龄（岁， $x ¯$ ±s）	57.36±12.98	56.80±13.49	t=0.145	0.885
性别［例（%）］			χ²=1.117	0.374
男	31（62.0）	7（46.7）
女	19（38.0）	8（53.3）
临床症状（例）
发热	4	0	-	0.566
盗汗	0	0	-	-
体质量下降	6	1	χ²=0.012	0.913
腹痛	13	5	χ²=0.052	0.820
体检发现	8	6	χ²=2.641	0.104
原发恶性肿瘤病史［例（%）］			-	＜0.001
有	0（0）	6（40.0）
无	50（100）	9（60.0）

超声特征	淋巴瘤（n=50）	转移癌（n=15）	统计值	P值
形态学分型			χ²=17.409	＜0.001
弥漫型	22（44.0）	0（0）
粟粒结节型	2（4.0）	0（0）
孤立型	14（28.0）	13（86.7）
混合型	12（24.0）	2（13.3）
病灶最大径（cm， $x ¯$ ±s）	5.31±2.56	6.23±3.55	t=-0.979	0.333
病灶最大径（cm）			χ²=1.598	0.713
≤1	2（7.1）	0（0）
＞1，≤3	4（14.3）	2（13.3）
＞3，≤6	12（42.9）	9（60.0）
＞6	10（35.7）	4（26.7）
病灶数目			-	0.023
单发	14（50.0）	13（86.7）
多发	14（50.0）	2（13.3）
病灶回声			χ²=5.047	0.046
实性	24（89.3）	9（60.0）
囊实性	3（10.7）	6（40.0）
囊性	1（3.6）	0（0）
边界			χ²=1.408	0.318
清晰	20（71.4）	8（53.3）
不清晰	8（28.6）	7（46.7）
形态			χ²=0.882	0.509
规则	19（67.9）	8（53.3）
不规则	9（32.1）	7（46.7）
血流信号			χ²=0.782	0.521
有点线状血流信号	11（39.3）	8（53.3）
无明显血流信号	17（60.7）	7（46.7）
脾增大			χ²=15.537	＜0.001
有	38（76.0）	3（20.0）
无	12（24.0）	12（80.0）
腹腔及腹膜后淋巴结长大			-	0.717
有	10（20.0）	2（13.3）
无	40（80.0）	13（86.7）

超声特征	淋巴瘤（n=50）	转移癌（n=15）	统计值	P值
形态学分型			χ²=17.409	＜0.001
弥漫型	22（44.0）	0（0）
粟粒结节型	2（4.0）	0（0）
孤立型	14（28.0）	13（86.7）
混合型	12（24.0）	2（13.3）
病灶最大径（cm， $x ¯$ ±s）	5.31±2.56	6.23±3.55	t=-0.979	0.333
病灶最大径（cm）			χ²=1.598	0.713
≤1	2（7.1）	0（0）
＞1，≤3	4（14.3）	2（13.3）
＞3，≤6	12（42.9）	9（60.0）
＞6	10（35.7）	4（26.7）
病灶数目			-	0.023
单发	14（50.0）	13（86.7）
多发	14（50.0）	2（13.3）
病灶回声			χ²=5.047	0.046
实性	24（89.3）	9（60.0）
囊实性	3（10.7）	6（40.0）
囊性	1（3.6）	0（0）
边界			χ²=1.408	0.318
清晰	20（71.4）	8（53.3）
不清晰	8（28.6）	7（46.7）
形态			χ²=0.882	0.509
规则	19（67.9）	8（53.3）
不规则	9（32.1）	7（46.7）
血流信号			χ²=0.782	0.521
有点线状血流信号	11（39.3）	8（53.3）
无明显血流信号	17（60.7）	7（46.7）
脾增大			χ²=15.537	＜0.001
有	38（76.0）	3（20.0）
无	12（24.0）	12（80.0）
腹腔及腹膜后淋巴结长大			-	0.717
有	10（20.0）	2（13.3）
无	40（80.0）	13（86.7）

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