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Radiation-induced splenic atrophy in patients with Hodgkin's disease and non-Hodgkin's lymphomas

Journal Article · · New Engl. J. Med.; (United States)
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Effective treatment of Hodgkin's disease requires the determination of the extent of the disease. This usually involves staging laparotomy, which includes splenectomy and biopsies of the para-aortic lymph nodes, liver, and bone marrow. Absence of the spleen predisposes a person to fulminant septicemia from encapsulated bacteria, a risk even greater in patients undergoing treatment for Hodgkin's disease. For this reason, some investigators have suggested that spleens not be removed for diagnosis but, rather, that they be included within the fields of radiation, which would preserve normal splenic function. We present a case of fatal spontaneous pneumococcal sepsis in a patient with splenic atrophy; the sepsis occurred 12 years after successful treatment of Hodgkin's disease by total nodal and splenic irradiation. A retrospective study of patients treated for Hodgkin's and non-Hodgkin's lymphomas indicated that atrophy and functional asplenia may be an important sequela of splenic irradiation.

Research Organization:
Stanford Univ., CA
OSTI ID:
5557983
Journal Information:
New Engl. J. Med.; (United States), Journal Name: New Engl. J. Med.; (United States) Vol. 302:4; ISSN NEJMA
Country of Publication:
United States
Language:
English

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Related Subjects

550603 -- Medicine-- External Radiation in Therapy-- (1980-)
560151* -- Radiation Effects on Animals-- Man
62 RADIOLOGY AND NUCLEAR MEDICINE
63 RADIATION, THERMAL, AND OTHER ENVIRON. POLLUTANT EFFECTS ON LIVING ORGS. AND BIOL. MAT.
ATROPHY
BIOLOGICAL EFFECTS
BIOLOGICAL RADIATION EFFECTS
BODY
DELAYED RADIATION EFFECTS
DISEASES
FRACTIONATED IRRADIATION
HODGKINS DISEASE
IRRADIATION
LOCAL IRRADIATION
LYMPHOMAS
MEDICAL SURVEILLANCE
MEDICINE
NEOPLASMS
NUCLEAR MEDICINE
ORGANS
PATHOLOGICAL CHANGES
PATIENTS
RADIATION EFFECTS
RADIOINDUCTION
RADIOLOGY
RADIOTHERAPY
SIDE EFFECTS
SPLEEN
THERAPY