Focal splenic lesions in 19 patients with malignant lymphoma were studied by ultrasonography, and the
findings were compared with histologic findings based on the classification of the Lymphoma Study
Group. All of the observed lesions were hypoechoic, and they were classified into four types: type I: numerous
minute lesions ranging from 2 to 3 mm in diameter and scattered diffusely in a mesh-like pattern; type II: many
ill-defined small irregular nodules ranging from 0.5 to 1.0 cm in diameter; type IE: one or a
few well-defined round nodules of 1.0 to 3.0 cm in diameter; and type IV: one or a few well-defined round
nodules of more than 3.0 cm in diameter. Type I splenic involvement was significantly more often associated
with splenomegaly than were the other types (p=0.034). Hodgkin's Disease and non-Hodgkin's lymphoma
of the diffuse large cell type were associated with type IV splenic involvement, whereas non-Hodgkin's
lymphomas of diffuse small and medium-sized cell types were associated with type I involvement.
Nodular lesions in types II through IV responded well to chemotherapy; type I miliary lesions did
not. Ultrasonographic appearance of splenic lesions, would thus appear to predict responsiveness to
chemotherapy as well as to indicate the underlying histology.