Clinical and Histopathological Findings in Patients Who Underwent Splenectomy: A Ten-Year Study in Iran

The description of histopathological features of spleen specimens in those undergoing splenectomy is necessary and even vital for selecting the best patient's diagnostic and therapeutic management. However, in some cases, the histological findings of those with dramatic clinical presentation may be imperceptible and vice versa.

What we did in the present study was to assess the clinical and histopathological findings as well as the main indications for splenectomy in a sample of Iranian affected population.

This cross-sectional study was conducted on 616 spleen specimens following complete or partial splenectomy performed at pathology laboratory at Besat Hospital in Hamadan, Iran between 2007 and 2017. Demographic characteristics, the main reasons for splenectomy, grading of trauma, and histopathological findings were retrospectively collected by reviewing the hospital recorded files and laboratory reports.

The most common cause for splenectomy included trauma in 59.25% followed by idiopathic thrombocytopenic purpura in 15.58% and symptomatic splenomegaly in 9.09%. The specimens were normal in 38.0%. Among those with lymphoma, the definitive diagnosis included diffused large B cell lymphoma in 42.85%, Hodgkin lymphoma in 42.85%, Follicular cell lymphoma in 9.52% and Marginal cell lymphoma in 4.76%.

Trauma and idiopathic thrombocytopenic purpura are the most common indications for splenectomy. Given the normality of the pathologic findings in more than one-third of patients undergoing splenectomy, closer attention to indications for this procedure through further evaluation of patients and predicting outcome of the procedure is necessary.