HYPOTHESIS: The incidence of primary @entity706 in @entity1 with idiopathic @entity381 is significant. DESIGN: Retrospective review of all @entity1 referred to a general surgical service for splenectomy. SETTING: A large tertiary care hospital. @entity1 : Between 1994 and 2001, 86 nontrauma @entity1 were referred for splenectomy. Of these, 18 had idiopathic @entity381 despite prior workup with computed tomography, peripheral smear, bone marrow biopsy, and laboratory testing. All @entity1 were symptomatic and displayed varying degrees of @entity1503 . INTERVENTION: All 18 @entity1 underwent open splenectomy for diagnosis and treatment of their @entity1503 . MAIN OUTCOME MEASURE: Incidence of @entity706 in the pathologic specimens. RESULTS: The mean size of the spleens was 21 cm (range, 14-34 cm) and mean weight was 996 g (range, 320-1840 g). In all 18 @entity1 , the surgical specimen provided a diagnosis. @entity370 was discovered in 4 @entity1 , and 1 @entity1 had @entity12692 . Six @entity1 with the benign diagnosis of @entity6118 received no further interventions, and the @entity1503 resolved in all 6 cases. The 7 remaining @entity1 (39%) were diagnosed with @entity706 . Five had marginal @entity706 , and 2 had a more @entity1892 . Three @entity1 required chemotherapy, but 4 are still in remission since their splenectomies and show no evidence of active disease. The mean follow-up was 20 months. CONCLUSIONS: A high percentage of @entity1 with @entity381 of unknown etiology will have primary @entity706 . Splenectomy is both diagnostic and therapeutic and should be considered for all @entity1 with idiopathic @entity381 .

Surgical indications in idiopathic XXXX .

@entity1 :: ('9606', 'Species') :: ['patients', 'PATIENTS', 'patient'] @entity706 :: ('MESH:D008223', 'Disease') :: ['lymphoma', 'zone lymphoma', 'lymphoma of the spleen'] @entity12692 :: ('MESH:D005871', 'Disease') :: ['Castleman disease'] @entity1503 :: ('MESH:D006402', 'Disease') :: ['cytopenia', 'cytopenias'] @entity1892 :: ('MESH:D016393', 'Disease') :: ['aggressive B-cell lymphoma'] @entity381 :: ('MESH:D013163', 'Disease') :: ['splenomegaly'] @entity6118 :: ('MESH:D006971', 'Disease') :: ['hypersplenism'] @entity370 :: ('MESH:D012507', 'Disease') :: ['Sarcoidosis']
@entity381 :: (MESH:D013163,Disease) :: ['splenomegaly']
