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Spleen Path Exam 2 WQ (:star2:
Splenomegaly (Infections
CMV, EBV
…
Spleen Path Exam 2 WQ
:star2:
Splenomegaly
Immunologic - Inflammatory Disease
(RA, SLE, Amyloidosis, Sarcoidosis)
Infections
- CMV, EBV
- Enlargment up to 400 gm - soft pulp
-
-
-
Storage disease --> Massive splenomegaly
(Gaucher's disease, Niemann Pick, Hurler Hunter)
-
-
Primary Neoplasms
- Angiosarcoma
- Malignant Lymphoma
Metastases uncommon
Infarct Risk
:star:Occlusion of Splenic Artery / Branches
- Heart embolus
- Sickle cell anemia
- DIC
- White anemic wedge-shaped infarct
- Sharp LUQ pain
Rupture:
Spontaneous Rupture
- Infectious mono
- Malaria
- Typhoid
- Acute splenitis
- Leukemia
-
Clinical Presentation of Rupture:
- Massive intraabdominal hemorrhage
- Hypovolemic shock
- Prompt surgical removal
Anomalies of Spleen
-
Accessory Splenule
- <2 cm
- Common!
- Asymptomatic (commonly)
- Undergo torsion
Post-Splenectomy
CBC Labs:
- NRBCs
- Howell-Jolly Bodies
- Target Cells
- Heinz bodies (special stain)
-
Functions:
- Filter stuff from blood:
-- destroys senescent RBCs
-- cleans RBC inclusions (Howell Jolly, Heinz Bodies)
-- removes bacteria, macromolecules, cell debris
- Major 2* immune organ - humoral immunity
- Source: lymphoreticular cells & hematopoietic cells (extramedullary hematopoiesis
- Reserve pool & storage 30-40 ml RBCs & 30-40% platelets
Hypersplenism Triad:
- Splenomegaly
- Thrombocytopenia
- Increased platelet production by bone marrow