Surgical treatment of lymphoma

At present, the treatment of malignant lymphoma emphasizes the importance of pathological diagnosis, classification and staging before treatment, and emphasizes individualized comprehensive treatment plans based on pathological classification, including surgery, chemotherapy, radiotherapy, biological therapy, hematopoietic stem cell transplantation, etc. In recent years, the efficacy has made significant progress.

In general, surgery is not required except for biopsy of superficial or deep lymphatic hematopoietic tissue to clarify the pathological type and stage of malignant lymphoma. However, surgical treatment is recommended in certain clinical situations.

Splenectomy is indicated for lymphoma originating from the spleen or patients with hypersplenism. Splenectomy is effective for some lymphomas, such as splenic marginal zone B-cell lymphoma. Splenectomy can improve blood routine and create favorable conditions for chemotherapy.

Malignant lymphoma originating from the gastrointestinal tract should be treated with surgery. The site of the lesion can be identified, the lesion tissue can be removed, and a later treatment plan can be developed. The resection rate of lymphoma is higher than that of cancer. Subtotal gastrectomy can be performed for gastric lymphoma, but total gastrectomy should be used with caution. For intestinal lymphoma, local lesions of the intestine and the corresponding mesentery can be removed. For tumors that cannot be completely removed, silver clips can be placed during surgery to facilitate postoperative radiotherapy. If there is a huge ulcer in gastrointestinal lymphoma and the involvement is extensive, it often leads to acute abdominal symptoms such as massive gastrointestinal bleeding, acute perforation or intestinal obstruction, and emergency surgery should be performed for treatment.

Mucosa-associated lymphoid tissue lymphoma (MALT lymphoma) that occurs in the lungs, salivary glands, thyroid gland, etc. is an indolent lymphoma. After local surgical resection, without any treatment, there may be no changes in the condition during many years of follow-up.

Malignant lymphoma originating from organs of the urogenital system such as the kidney, bladder, testicles, ovaries and uterus should be surgically removed at an early stage, followed by radiotherapy or chemotherapy.

Malignant lymphoma can affect bones and joints. If it involves the thoracic and lumbar vertebrae, it can cause body deformities, affect the stability and activity of the musculoskeletal system, and cause neurological symptoms (pain, paraplegia). In this case, surgical treatment can be chosen first.