Clinical staging of malignant lymphoma in patients suspected to have hepato-splenic schistosomiasis.

Exploratory laparotomy, splenectomy and liver biopsy were carried out as a pre-treatment staging procedure in 32 cases of pathologically proved malignant lymphoma with clinically palpable spleen. The spleen was found to be negative for lymphoma in 17 cases, of which liver pathology showed bilharzial hepatic fibrosis in eight cases, nutritional cirrhosis in two cases and non-caseating granuloma in three cases. The liver was clinically positive in 13 cases. After laparotomy, three cases showed bilharzial pathology only. Bilharziasis has accounted for about one half of the false positive hepato-splenic involvement. These findings exemplify the usefulness of laparotomy as a staging procedure in regions endemic for hepato-splenomegaly.