4. Diseases of the Spleen

Question 1

Definition of splenomegaly

Answer 1

Enlargement of the spleen; the key symptom in splenic diseases

Question 2

Causes of splenomegaly

Answer 2

1. Infections
   - Infectious endocarditis
   - EBV
   - CMV
   - Tuberculosis
   - Malaria
   - Syphilis
   - Typhoid fever
   - Brucellosis
2. Congestion (congestive splenomegaly)
   - Portal hypertension
   - Congestive heart failure (less marked splenomegaly)
3. Lympho-hematogenous disorders
   - Lymphomas
   - Leukemias
   - Hemolytic anemia
4. Immunologic-inflammatory conditions
   - Rheumatoid arthritis
   - Systemic lupus erythematosus
5. Storage disease
6. Others
   - Amyloidosis
   - Neoplasms

Question 3

Pathological effects of splenomegaly

Answer 3

Hypersplenism:

1. Anemia
2. Leukocytopenia
3. Thrombocytopenia

Question 4

Causes of splenic infarct

Answer 4

1. Valvular heart disease
   - Infectious endocarditis (results in septic emboli)
   - Gives rise to septic infarct with suppurative necrosis
2. Acute myocardial infarction & arrhythmias
   - Results in thromboembolism of splenic artery
   - Gives rise to a pale wedge-shaped infarct
3. Atheromatous disease
   - Splenic artery atheromatous plaque