Certain clinical and imaging findings can identify a spleen that is involved by malignant lymphoma. The criteria were developed at the 12th International Conference (2013) for Malignant Lymphoma in Lugano, Switzerland.
Patient selection: malignant lymphoma, Hodgkin's or non-Hodgkin's disease
Parameters:
(1) findings on physical examination
(2) findings on appropriate imaging study
If the lymphoma shows FDG ([18F]-fluorodeoxyglucose) avidity (based on histology) then PET-CT imaging is performed, else CT.
Criteria for splenic involvement:
(1) palpable spleen
(2) positive imaging findings
Findings on PET-CT Scan
Findings on CT Scan
diffuse FDG uptake
> 13 cm in vertical length
solitary mass
solitary mass
miliary lesions
miliary lesions
nodules
nodules
The diagnostic certainty increases if other causes of splenic enlargement or increased FDG uptake are excluded.
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