Primary malignant tumors of the spleen

　　The cause of spleen tumors has not been fully elucidated yet, but some possible related factors for the occurrence of spleen tumors have been found in recent 30 years, such as infection factors (some viruses, mycobacteria, Plasmodium, etc.), genetic factors, and other chronic spleen diseases. There are many clinical and immunological similarities between the splenic lymphoma with villous lymphocytes in West Africa and the splenic enlargement in highly reactive malaria, which provides clues for the study of the pathogenesis of lymphoma. After analyzing these literature, it is found that after the spleen is infected with viruses, bacteria, and other pathogens, a non-specific immune response occurs, stimulating the accumulation and proliferation of B lymphocytes or T lymphocytes in the spleen inflammatory area. Under the condition that some internal factors lose balance, this proliferation may become unrestricted and develop into a tumor. In addition, genetic factors and some chronic spleen diseases may also be related to the occurrence of spleen tumors.

　　Enlarged spleen can produce compressive symptoms on surrounding organs, such as intestinal obstruction when compressing the intestines, and upper urinary tract obstruction when compressing the left ureter. There are also some cases where spontaneous rupture of the tumor causes intra-abdominal hemorrhage to be the first symptom for seeking medical attention. Intestinal obstruction refers to the obstruction of intestinal contents, simply put, it is an unsmooth intestinal tract, and here the intestines usually refer to the small intestine (jejunum, ileum) and the large intestine (ascending colon, transverse colon, descending colon, sigmoid colon).

　　Primary malignant tumors of the spleen often have no specific symptoms in the early stage, and patients often present with advanced cancerous states when seeking medical attention, specifically表现在:

　　1. The spleen's own manifestations:The enlarged spleen is mostly below the umbilical level, with some literature reporting that the maximum can reach 7.5 cm below the umbilicus, showing a gradual increase in size, hard texture, uneven surface, poor mobility, and significant tenderness.

　　2. Local compressive symptoms caused by the tumor:Symptoms such as fullness in the stomach area, loss of appetite, abdominal distension, palpitations, and shortness of breath.

　　3. Toxic manifestations of malignant tumors:Symptoms such as low fever, fatigue, anemia, and weight loss may occur, with some cases showing high fever. Approximately one-fourth of the cases may be accompanied by liver enlargement, while the spleen shows irregular enlargement without long-term fever and without hypersplenism, which are characteristic of primary malignant tumors of the spleen.

　　To prevent primary malignant tumors of the spleen, it is first necessary to develop good living habits and quit smoking and limit alcohol consumption. The World Health Organization predicts that if people stop smoking, within 5 years, cancer worldwide will decrease by one-third; secondly, do not overindulge in alcohol. Cigarettes and alcohol are extremely acidic substances, and those who smoke and drink long-term are prone to develop an acidic constitution.

　　Secondly, do not eat too much salty and spicy food, do not eat overheated, cold, expired, and deteriorated food; for the elderly, the weak, or those with certain disease genetic genes, eat some cancer-preventive foods and alkaline foods with high alkaline content in moderation, maintain a good mental state.

　　Imaging examinations play a crucial role in the diagnosis of spleen tumors. X-ray examination can detect the enlargement of the spleen shadow and local compression signs, but it is not specific; B-ultrasound examination can determine whether there is a mass in the spleen, whether it is solid or cystic, but cannot distinguish between benign and malignant; percutaneous needle biopsy has a higher risk and the puncture site is difficult to pinpoint; CT and MRI not only show the lesions of the spleen itself but also show the relationship between the mass and adjacent organs, invasion of the lymph nodes or liver, and other lesions in the abdomen and thorax; selective splenic arteriography can show signs such as defects in the spleen substance.

　　To prevent the occurrence of primary malignant tumors of the spleen, everyone should avoid greasy, cold, and difficult-to-digest foods. Do not eat too much salty and spicy food, do not eat overheated, cold, expired, and deteriorated food; for the elderly, the weak, or those with certain disease genetic genes, eat some cancer-preventive foods and alkaline foods with high alkaline content in moderation, maintain a good mental state. Develop good living habits, quit smoking and limit alcohol.

　　To improve the cure rate of spleen malignant tumors, early detection, early diagnosis, and early comprehensive treatment are advocated. The main method is splenectomy, with attention to the integrity of the spleen capsule and the清扫 of the lymph nodes around the hilum of the spleen during the operation. Chemotherapy or radiotherapy, traditional Chinese medicine, immunotherapy, and other adjuvant treatments are given before and after the operation.

　　1. Hodgkin's Lymphoma

　　MOPP is the preferred regimen, that is, nitrogen mustard (M), vincristine (O), procarbazine (P), and prednisone (P).

　　2. Non-Hodgkin's Lymphoma

　　The efficacy of chemotherapy depends on the pathological tissue type, and combined chemotherapy regimens are selected according to the degree of malignancy. For those with low malignancy, chemotherapy may not be needed after splenectomy, and regular close observation should be carried out. If there is progression of the disease or complications, COP, that is, cyclophosphamide (C), vincristine (O), and prednisone (P), may be administered.