The spleen, a fist-sized organ located under the left rib cage, plays a role in the body’s immune system and blood filtration. It removes old or damaged blood cells and helps fight infections by producing white blood cells and antibodies. Like any organ, the spleen can be affected by cancer, either originating within it or spreading from other parts of the body. Identifying such a condition involves a series of diagnostic steps.
Recognizing Potential Symptoms
Individuals might notice several signs that suggest a spleen-related issue. A common indicator is an enlarged spleen, known as splenomegaly, which can cause pain or a feeling of fullness in the upper left abdomen. This discomfort might radiate to the left shoulder or back, and an enlarged spleen can press on the stomach, leading to a feeling of fullness after eating only a small amount of food. Beyond localized symptoms, systemic signs like unexplained weight loss, persistent fatigue, fever, and night sweats can also occur.
First Steps in Medical Assessment
When spleen cancer is suspected, the initial medical assessment begins with a physical examination. During this exam, a doctor will palpate the abdomen, particularly the upper left quadrant, to check for any enlargement of the spleen. Initial blood tests are also commonly ordered, such as a complete blood count (CBC). A CBC can reveal abnormal levels of red blood cells, white blood cells, or platelets, which might indicate an underlying issue affecting the blood or bone marrow, often associated with spleen cancers like lymphoma or leukemia.
Advanced Imaging and Blood Tests
Further investigation involves advanced imaging techniques to visualize the spleen and surrounding structures. An ultrasound of the abdomen is a common starting point, as it is non-invasive and can assess the spleen’s size, shape, and internal texture, identifying any abnormal growths or masses. Computed Tomography (CT) scans provide more detailed cross-sectional images, which are valuable for detecting smaller lesions, assessing the extent of any enlargement, and determining if cancer has spread to nearby lymph nodes or other organs. Magnetic Resonance Imaging (MRI) offers superior soft-tissue contrast, making it particularly useful for characterizing splenic lesions and evaluating blood flow. MRI can help differentiate between benign and malignant lesions and is highly sensitive for detecting certain types of tumors or metastases. Positron Emission Tomography (PET) scans, often combined with CT (PET-CT), provide functional information by highlighting areas of increased metabolic activity. This combined imaging is especially useful for staging lymphomas and identifying metabolically active tumors. In addition to imaging, specific blood markers like lactate dehydrogenase (LDH) may be elevated in certain cancers.
Definitive Diagnostic Procedures
To confirm a diagnosis of spleen cancer, a biopsy is necessary, involving taking a tissue sample from the suspicious area for microscopic examination. This analysis can definitively identify cancer cells, determine the specific type of cancer, and assess its characteristics. While a direct splenic biopsy can be performed, it is less common due to the risk of bleeding. In many cases, if spleen cancer is suspected, particularly lymphoma or leukemia, a bone marrow biopsy may be performed, as these blood cancers often affect the bone marrow and spleen simultaneously; lymph node biopsies might also be considered if enlarged lymph nodes are present, as cancer often spreads through the lymphatic system. The pathologist’s analysis of these tissue samples provides the conclusive diagnosis, guiding treatment decisions.