Objective  The current work aims to investigate the surgical indication and curative effect of surgery on primary splenic lymphoma.

  Methods  The clinical data of 34 cases with primary splenic lymphoma treated at The First Affiliated Hospital of Soochow University from January 2002 to December 2010 were analyzed in retrospect.

  Results  Left upper abdominal pain and abdominal distension (13 cases, 38.2%), and B symptoms (5 cases, 14.7%) were the main clinical symptoms of the primary splenic lymphoma. A total of 30 cases suffered moderate to high degrees (88.2%) of splenomegaly. Based on the Ahmann clinical staging of splenic lymphoma, the stage Ⅰ disease accounted for 11 of the patients (32.4%), stage Ⅱ accounted for 3 (8.8%), and stage Ⅲ accounted for 19 (55.9%). There was a definite diagnosis in 12 of the cases after surgery (35.3%). The splenomegaly or hypersplenism was relieved in 11 of the cases (32.4%). Open splenectomy was conducted in 29 cases (85.3%) and laparoscopic or hand-assisted laparoscopy-supported splenectomy was conducted in 5 cases (14.7%). Histopathology showed that non-Hodgkin lymphoma accounted for 33 of the cases (97.1%), of which 29 were B-cell lymphoma and 4 were T-cell lymphoma. One case was Hodgkin's disease. Postoperative complications occurred in 9 of the cases (26.5%), with an incidence of death in 4 cases (11.8%).

  Conclusion  Splenectomy improves the survival rate of stage Ⅰ/Ⅱ primary splenic lymphoma and relieves the splenomegaly. Moreover, splenectomy could be used for further diagnosis. Laparoscopic splenectomy or hand-assisted laparoscopy is conducive to the recovery of patients with primary splenic lymphoma.