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Surgery of non-Hodgkin lymphoma

Surgery is rarely indicated for non-Hodgkin lymphoma.

The following surgical procedures may be appropriate in some cases

  • Lymph node biopsy
  • Explorative laparotomy
  • Splenectomy
  • Resection of the stomach or intestines invaded with lymphoma

Explorative laparotomy

Non-Hodgkin lymphoma in the intestines may debut as ileus, bleeding, or intestinal perforation. 

Explorative laparotomy is performed if the diagnostic examinations performed do not clarify the disease status in the abdomen, and where clarification of this would lead to significant therapeutic consequences. Explorative laparotomy, possibly laparoscopy is also performed if a diagnosis cannot be made by another method, for example ultrasound-guided biopsy. 

Splenectomy

A splenectomy is often indicated as the first choice of treatment for splenic marginal zone B cell lymphoma.

If the spleen is involved at the start of treatment, a splenectomy will be considered in some cases after chemotherapy is finished. This is done to clarify whether residual disease still exists. A splenectomy is also a good alternative to local radiotherapy.  

Primary tumor resection with GI tract involvement

Primary tumor resection of lymphoma in the stomach was previously performed routinely. It is now reserved for cases of:

  • great risk for bleeding
  • perforation after starting chemotherapy

A resection may be appropriate for intestinal lymphoma:

  • to determine a diagnosis
  • with ileus
  • with bleeding conditions

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