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Spleen Pathology
Powerpoint
25
Pathology
Undergraduate 2
03/23/2011

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Cards

Term

Splenomegaly

Definition

Splenic enlargement

> 13 cm in length

Usually due to abnormalities in other organs

Most common finding when examining the spleen

Examine the contour of the spleen to determine if a pathologic process involves the spleen

S & S: LUQ pain or fullness

Term
Splenic Congestion
Definition

Classified as acute and chronic

Acute: hyperemia accompanies the moderate enlargement

Chronic venous congestion:  diffuse enlargement of the gland

*Etiology usually due to obstructive blood disease

Term
Storage Disease
Definition

Amyloidosis: metabolic abnormality causing deposits of “starch-like” substances in tissue

Spleen is the organ most affected

US findings of normal to enlarged spleen

Term
Storage Disease
Definition

Gaucher’s disease: congenital disorder of lipid metabolism

US findings of inhomogeneous splenomegaly with multiple hypoechoic lesions

Niemann-Pick disease:  fatal disturbance of sphingolipid metabolism

US findings of hepatosplenomegaly and  lymphadenopathy

Term

Storage Disease

Definition

Niemann-Pick disease:  female predominance—patient usually dies by age three

Term
Diffuse Disease
Definition

Sickle cell anemia

Hereditary or congenital spherocytosis

Hemolytic anemai

Polycythemia vera

Thallassemia

Term
Diffuse Disease
Definition

Myeloproliferative disorders

Granulocytopoietic abnormalities

Reticuloendotheliosis

Letter-Siwe disease

Hand-Schuller-Christian disease

Term
 Sickle Cell Anemia
Definition

Inherited hematologic disease particular to those of African descent

RBCs are ‚ shaped rather than œ

US findings—depends on disease state

Term
Sickle Cell Anemia
Definition

Acute crisis might yield an enlarged spleen with a decrease in hematocrit.  With increasing crisis, spleen would become smaller with areas of infarction and fibrosis

Hereditary or congenital spherocytosis

  RBC are small and round rather than disc shaped

  US findings of splenomegaly

Hemolytic anemia

  RBC destruction is greater than the bone marrow can rebuild

  Autoimmune hemolytic anemia develops as a primary anemia or due to   underlying disease such as lymphoma, leukemia or infectious mononucleosis.

  US findings in secondary form are dominated by the underlying disease in the   primary form the spleen is enlarged

Term
Thalassemia
Definition

Inherited hematologic disease particular to individuals from the Mediterranean or SE Asia

Anemia due to deficient synthesis of of hemoglobin

US findings

Term

Thalassemia

Definition

US findings of a grossly enlarged spleen

Polycythemia vera
chronic disease of unknown etiology seen as an increase in RBC mass and hemoglobin concentration.
S & S of fatigue, vertigo, tinnitus, irritability, splenomegaly, flushing of the face, redness and pain in the extremities and bruising
US findings of an enlarged, turgid, spleen.  Infarcts and thrombosis are common in polycythemia vera

Term
Myeloproliferative Disorders
Definition

Include acute and chronic myelogenous leukemias, polycythemia vera, myelofibrosis, megakaryocytic leukemia and erythroleukemia

Term
Myeloproliferative Disorders
Definition

Granulocytopoietic  abnormalities
Reactive hyperplasia resulting from acute or chronic infection (TB and histoplasmosis are examples)
US findings of echogenic foci in the spleen
Letterer-Siwe disease and Hand-Schuller-Christian disease are both seen in pediatric patients as hepatosplenomegaly by sonography

Term
Lymphopoietic Abnormalities
Definition

Include lymphocytic leukemias, lymphoma, and Hodgkin’s disease

US findings of a diffusely hypoechoic spleen with focal lesions

Term
Lymphopoietic Abnormalities
Definition

Leukemia

Chronic leukemia is a major cause of  splenomegaly

Term
Focal Disease of the Spleen
Definition

Splenic abscess

Usually due to suppressed immune system, subacute bacterial endocarditis

S & S of LUQ tenderness, abd pain

US findings vary

Term
Splenic Infection
Definition

Most often presents as splenomegaly

More often seen in immunocompromised patients

Term
Other Focal Disease of the Spleen
Definition

AIDS

Splenomegaly with possible focal lesions

Splenic infarction & trauma

due to  occlusion of the splenic artery

US findings

Term
Other Focal Disease of the Spleen
Definition

Splenic infarction & trauma

due to  occlusion of the splenic artery

US findings of a focal, wedge-shaped defect that varies in appearance depending on the time of onset

Term
Splenic Trauma
Definition

Usually due to blunt abdominal trauma

Hematoma may result

May be subcapsular or may be ruptured

Must assess for free fluid in the intraperitoneum

Term
Additional Focal Lesions of the Spleen
Definition

Splenic cysts

May be parasitic or nonparasitic in origin

US findings are of a true cyst

Term
Malignant Primary Neoplasms
Definition

Lymphoma

Usually seen as hypoechoic lesions

Patterns of

Diffuse involvement

Focal small nodular lesions

Focal large lesions

Bulky disease

Term
Malignant Primary Neoplasms
Definition

Mets may originate from primary breast, lung, ovary , stomach, or prostate—most commonly from melanoma

Term
Endocarditis
Definition
Inflimation of the lining of the heart:
Term
melanoma
Definition
What kind of cancer is the most common found in the spleen?
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