Spleen diseases: symptoms of the most common diseases

Malignant tumors of the spleen are very rare. They can be primary (when the tumor initially develops in the spleen) or metastatic (when tumor cells from other organs spread to the spleen).

• Causes of development and risk groups
• Classification, stages
• Symptoms of spleen cancer
• Metastases in spleen cancer
• Diagnostic methods
• Treatment of spleen cancer
• Complications
• Recurrence of cancer
• Survival prognosis
• Prevention

Causes of development and risk groups

Malignant tumors develop as a result of mutations that occur in cells. These mutations affect genes that regulate cell reproduction, apoptosis (programmed cell death), and repair of damaged DNA. It is difficult to say why such mutations occurred in each specific case.

Some conditions increase your chance of developing cancer—they are called risk factors. If we talk about the most common type of spleen cancer - lymphoma, then the risk factors will be as follows:

• Age. Over the years, mutations accumulate in the cells of the human body and the likelihood of developing various types of cancer increases.
• Floor. Men get sick more often.
• Family history: if lymphoma has been diagnosed in close relatives.
• Immune system disorders: weakened immunity, autoimmune diseases.
• Exposure to the body of certain harmful substances.
• Some studies have found a link between chronic hepatitis C and B-cell non-Hodgkin lymphoma.

Spread of the disease.

Spleen cysts are observed in 0.5 - 1% of the population. Moreover, in half of the patients, cysts are detected by chance, during a routine examination. In women, splenic cysts are 3–5 times more common than in men, and are detected mainly between 35 and 55 years. Similar to liver cysts, spleen cysts can be single, multiple, true or false.

Puchkov K.V., Ivanov V.V., Poddubny I.V., Tolstov K.N. Laparoscopic splenectomy: surgical tactics and technical aspects: monograph. - M.: ID MEDPRACTIKA - M. - 2007. - 88 p.

Classification, stages

“Spleen cancer” is not quite the correct term. Strictly speaking, cancer refers to tumors that originate from epithelial tissue. In the spleen, malignant neoplasms develop from other types of tissue. Their classifications have changed over time and differ among different authors. Currently, doctors are often guided by the L. Morgenstern classification, developed in 1985. In accordance with it, all malignant tumors of the organ are divided into three large groups: vascular, lymphoid and non-lymphoid:

Lymphomas most often occur in the spleen. However, primary organ damage is a rare occurrence. It is known that in non-Hodgkin's lymphoma the spleen is involved in 50–80% of cases, and this often occurs in Hodgkin's disease.

The most common vascular malignant tumor in the spleen is angiosarcoma. However, it is a very rare disease - it affects 1-3 people in ten million. Angiosarcoma originates from the tissues of the vascular wall, is highly aggressive, and quickly metastasizes.

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Where is the spleen located?

The spleen is located just below the ribs on the left side (Figure 1). It concerns the left kidney, left adrenal gland, posterior wall of the stomach, pancreas, diaphragm. This is a small organ, 10-15 cm long. It weighs about 150 grams, its shape is round and oblong. Normally, the spleen cannot be felt, but after injury or illness it can become greatly enlarged and even noticeably protrude from under the ribs³.

Figure 1. Where is the spleen located. Image: rob3000/Depositphotos

Symptoms of spleen cancer

Diagnosing spleen cancer based on symptoms is very difficult. Manifestations of the disease are nonspecific; they can occur in many pathologies, including other types of cancer. With lymphomas, 25% of patients have no complaints at all, and the tumor is diagnosed by chance.

Main symptoms:

• pain in the abdomen, usually in the upper left part;
• weakness, increased fatigue;
• weight loss for no apparent reason;
• increased body temperature;
• night sweats;
• enlarged subcutaneous lymph nodes: in the axillary and groin areas, on the neck;
• increased bleeding, which manifests itself in the form of bruises on the skin;
• decreased appetite;
• frequent infections.

It is important to pay attention to any unusual symptoms. If they persist for several days, you should consult a doctor. This helps to diagnose cancer and other diseases in a timely manner.

What to do if you have pain in the spleen?

Initially, spleen disease does not manifest itself as pain; pain often occurs after its significant enlargement. Therefore, as soon as the slightest discomfort appears in this area, the above signs of the disease are visible, you should immediately consult a therapist. After examining the patient, the doctor will be able to determine the condition of the organ using standard palpation during the period of inspiration. The doctor’s conclusion should also be confirmed by the results of modern tests, the necessary ultrasound and tomography studies.

It is worth treating the cause of the disease itself in order to avoid repeated failures in the functioning of the spleen. Having established a preliminary diagnosis, the therapist will refer you to the appropriate professional: an infectious disease specialist, hematologist, traumatologist, surgeon or oncologist. If treatment does not give the expected results, then the issue is resolved through surgery. Many doctors recommend eating right and leading a healthy lifestyle to prevent such serious consequences.

To quickly normalize the functioning of the lymphatic system, proper breathing is necessary. When you inhale and exhale deeply, the muscles that are responsible for the movement of the lungs stretch and put pressure on the lymph vessels of the intestine, which accelerates the movement of blood through the vessels. The functioning of the spleen will also improve through regular physical activity, special exercises and walking. In this case, rapid and deeper breathing is observed.

Author of the article:

Mochalov Pavel Alexandrovich |
Doctor of Medical Sciences therapist Education: Moscow Medical Institute named after. I. M. Sechenov, specialty - “General Medicine” in 1991, in 1993 “Occupational diseases”, in 1996 “Therapy”. Our authors

Diagnostic methods

With malignant neoplasms, an enlargement of the spleen is often observed. It can be detected during ultrasound, computed tomography, and magnetic resonance imaging. However, if the spleen is enlarged, this does not mean that a person has cancer. It may be a benign neoplasm.

If an enlarged spleen is detected, the doctor may prescribe a complete blood test and a red bone marrow test. The most accurate method for diagnosing a malignant tumor is a biopsy. Material for histological and cytological analysis can be obtained by puncture (using a hollow needle) or by removing the spleen.

Is it possible to diagnose spleen cancer in the early stages, before the first symptoms appear? There are no specific screening tests. There are no studies that can be recommended for all people to undergo regularly. People who have certain risk factors should pay increased attention to their health: viral hepatitis B and C, immunodeficiency conditions, autoimmune pathologies, treatment with immunosuppressants. If you begin to worry about the symptoms listed in this article, you need to visit a doctor and get checked.

Causes of splenomegaly

Why can the spleen be enlarged in an adult? The following conditions and diseases can lead to splenomegaly:

• bacterial process. Most often these are typhoid, paratyphoid, septic lesions of the body, tuberculosis and syphilis;
• viral infection. Splenomegaly can occur with diseases such as rubella, measles, viral hepatitis, and others;
• protozoal infection - when pathogens of malaria, leishmaniasis and toxoplasmosis are introduced into the body;
• mycoses – infection by pathogenic fungi;
• helminthiases – the presence of worms in the body;
• various variations of anemia (anemia);
• systemic chronic diseases of the hematopoietic organs - primarily leukemia;
• systemic autoimmune pathologies;
• endocrinological disorders – congenital and acquired.

Possible causes of splenomegaly in children and provocateurs of spleen enlargement in adults may be slightly different. Thus, splenomegaly in young patients:

• may be a variant of the norm (with a slight increase);
• occurs due to disturbances during the intrauterine development of this organ;
• occurs with an enlarged liver.

Before wondering how to treat an enlarged spleen, it is necessary to verify the exact causes of splenomegaly - often after their elimination, in the absence of complications, the spleen returns to its normal size.

Treatment of spleen cancer

Treatment approaches depend on the type and stage of the malignant tumor. For example, with lymphomas, if there are no symptoms, it is enough to go to the doctor for examinations and take blood tests every six months. If, for example, a metastasis of a solid tumor is detected in the spleen, active treatment is required. Below we will consider the basic principles of treatment of lymphomas as the most common tumors of the spleen.

Surgical interventions

The main type of treatment for splenic lymphoma is organ removal, splenectomy. Statistics show that most patients who undergo such surgery do not require any other types of treatment over the next five years.

Chemotherapy

In some cases, chemotherapy is used - drugs that destroy tumor cells. Some are administered intravenously, others are taken in tablet form. The type, dosage and schedule of administration of chemotherapy drugs are selected depending on the type and stage of the tumor.

Studies have shown that rituximab, a drug from the group of monoclonal antibodies, can be an effective alternative to splenectomy for lymphomas. It helps to get rid of symptoms and avoid complex surgery.

Radiation therapy

In some cases, radiation therapy is used to combat lymphomas. X-rays and proton therapy are used.

Radiation therapy is used as an independent type of treatment to combat tumors in the early stages. In later stages and with aggressive tumors, it is combined with chemotherapy. In addition, radiation helps combat symptoms caused by metastases.

Stem cell transplant

Stem cell transplantation (red bone marrow transplantation) is indicated in cases where the tumor cannot be treated with chemotherapy and radiation therapy. High doses of chemotherapy or radiation are given to suppress the patient's own red bone marrow, and then red bone marrow stem cells, either their own or a donor's, are injected into the patient's blood.

Complications

A malignant tumor can spread to the brain, spinal cord and cause neurological complications. Compression of the nerves leads to pain. Lesions in the lymph nodes, which are located inside the chest, can lead to coughing, difficulty breathing, and chest pain.

The spleen is not a vital organ, so after it is removed, a person can live as before without experiencing any symptoms associated with its absence. However, immune defenses are reduced to some extent and the patient becomes more vulnerable to infections.

Survival prognosis

The prognosis depends on the type, stage, and degree of aggressiveness of the tumor. In particular, with marginal zone cell lymphoma of the spleen , the prognosis is influenced by factors such as the patient's age, leukocytosis, lymphocytosis, leukopenia, thrombocytopenia, anemia, damage to the red bone marrow and other organs, the use of chemotherapy and monoclonal antibodies.

One of the researchers divided patients into risk groups and calculated their five-year survival (% of patients alive within 5 years from the date of diagnosis of the disease):

• low risk - 88%;
• average risk - 73%;
• high risk - 50%.

Functions in the body

The spleen is the largest lymphatic organ. As part of the immune system, it performs several important functions:

• Participates in the functioning of the immune system, ensuring the formation of lymphocytes. The spleen is directly involved in the production of B-lymphocytes - cells of the immune system. They recognize foreign structures and produce antibodies against them.
• Purifies the blood by capturing and destroying old, damaged platelets and red blood cells. Their breakdown products are then sent to the liver, where they are used in the formation of bile.
• Accumulates and stores blood, as well as platelets. Up to a third of all platelets in the body are stored in the spleen. The organ can also hold about 50 ml of blood. By dilating the blood vessels, the blood volume can be greatly increased if necessary.
• During fetal development, the spleen performs hematopoietic functions. By the time of birth, the bone marrow begins to perform them, but even after this, the spleen retains the ability to participate in hematopoiesis. In case of blood diseases, it can again begin to perform these functions⁴.

Prevention

It is now known that there is a connection between the development of malignant neoplasms of the spleen and infections such as hepatitis C, HIV infection, and infection caused by the T-cell lymphoma virus. It is recommended to follow recommendations that help prevent infection:

• Use condoms.
• If you decide to get a piercing or tattoo, choose a reliable salon.
• Do not inject with used needles.

A high fat diet and excess weight are two other risk factors for developing non-Hodgkin lymphoma. You need to eat a healthy diet and maintain a normal weight.

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