Chapter 11- Spleen Flashcards
What does the spleen produce during embryonic life?
Red and white blood cells.
The spleen is part of what body systems?
Lymph and reticuloendothelial systems
What are the normal measurements of a spleen
8-13 cm long, 7 cm wide, and 3 to 4 cm thick
What is a wandering spleen and what causes it?
spleen that has migrated from its normal location in the left upper quadrant caused by improper fusion of the dorsal mesentery with the posterior peritoneum
What are the most common causes of granulocytopoietic abnormalities?
Histoplasmosis and tuberculosis
What is sarcoidosis?
an inflammatory disease that affects lungs and lymph nodes. It is a granulocytopoietic infection.
What is a granuloma? How do they appear sonographically?
focal lesions resulting from previous infections. Hyperechoic foci throughout splenic parenchyma and possibly in the liver and lungs.
What is Reticuloendotheliosis?
Includes diseases characterized by reticulo-endothelial hyperactivity
and varying degrees of lipid storage in phagocytes.
What is Letterer-Siwe Disease?
Non-Lipid Reticuloendotheliosis Proliferation of reticuloendothelial cells throughout the body, particularly in bone marrow and spleen.
Who does Letterer-Siwe Disease affect? Is it common? What are symptoms?
It is rare with poor prognosis. It affects children under 2. Hepatosplenomegaly, fever.
What is Hand-Schuller-Christian Disease
Benign and chronic inflammatory disese that affects children older than 2 years. symptoms are diabetes and hepatosplenomegaly.
Is splenic abscess common? Why?
Uncommon, because of the phagocytic activity of the spleen’s efficient reticuloendothelial system and leukocytes
What are sonographic findings of Lymphopoietic abnormalities?
iso or hypoechoic splenic pattern with focal lesions
How might a splenic abscess apper if it occurs?
pyogenic, atypically pyogenic with gas reverberations, microabscesses with a target appearance
How might splenic infections appear?
splenomegaly. immunicomprimised patients have multiple nodules within the spleen
What is splenic candidiasis
a fungal infection that appears target-like that is found in immunocomprimised patients.
How do mycobacterial splenic infections appear?
tiny, diffuse echogenic foci throughout the spleen
How does Acquired Immunodeficiency Syndrome (AIDS) appear?
Multiple organs are involved liver, kidney etc. Moderate splenomegaly, Focal splenic lesions displaying small round lesions that may be multiple, hypoechoic, and well-defined.
What is the most common cause of a focal splenic lesion or infarction?
occlusion of the major splenic artery or any of its branches. This usually occurs as a result of emboli from the heart
What are symptoms and the appearance of a splenic infarction?
LUQ pain or asymptomatic. Peripheral, wedge-shaped lesions on the edge of a spleen. hypo or hyperechoic depending on age of bleed.
The spleen is most commonly injured as a result of …?
Blunt abdominal trauma
If the patient has severe left upper quadrant pain secondary to
trauma, what pathology should we consider?
splenic or subcapsular hematoma
What parts of the body is a Splenic Trauma FAST exam?
The RUQ, LUQ pericardial, and bladder regions will be examined for free fluid
Where do splenic cysts come from?
They may be congenital, acquired from infection trauma or infarction, or associated with polycystic disease
Where are small splenic cysts located? Where are large?
Small cysts are usually located within the parenchyma Large cysts can be exophytic?
What is different about a posttraumatic or pseudocyst?
They no not have a cellular lining but walls might be calcified.
What is Posttraumatic Splenosis
When a spleen is damaged, splenic cells can be released within the body and grow into additional spleens.
What is a primary congenital cyst called? What differentiates it?
Also called epidermoid cysts, it is diferentiated by the presence of an epithelial lining.
What splenic cyst comes from a parasite?
Echinococcal cysts
What is the first indication of a splenic abnormality?
splenomegaly
What are symptoms and sonographic appearance of Hamartoma?
Patient is asymptomatic. tumor might be solitary or multiple and well defined, hyperechoic and complex.
What is the most common benign splenic neoplasm
cavernous hemangioma
What is cavernous hemangioma and when would symptoms occur?
an isolated, echogenic mass with multiple small hypoechoic areas. the patient becomes symptomatic when the spleen swells and compresses organs or with rupture.
What is a cystic lymphangioma? How does it appear?
A benign malformation of lymphatic vessels, consisting of endothelium-
lined cystic spaces. Appears polycystic
What is hemangiosarcoma?
a rare, malignant neoplasm from the blood vessel’s epithelial cells of the spleen
What are symptoms and the appearance of hemangiosarcoma?
Anemia, LUQ pain, Leukocytosis.
Complex or hyperechoic
What are the two types of Lymphoma? What differentiates them?
Hodgkin’s (with the presence of Reed-Sternberg cells) and Non-Hodgkin’s
What is lymphoma
Malignant disorder involving the lymph system
What is leukemia and how does it appear sonographically?
Destruction of white blood cells. splenomegaly, echogenic areas, nodules
How common is metastasis in the spleen? What is the most common primary site of metastasis to the spleen.
The spleen is the tenth most common site of metastases. Melanoma is the most common rimary site.
How are splenic artery aneurysms most commonly identified?
They appear as a calcified circle on X ray.
What are risk factors of a splenic artery aneurysm? What demographic is most prevalent?
Atherosclerosis, portal hypertension. infection, trauma. Female prevalence.
What is Hereditary spherocytosis? What is the main symptom?
RBCs are shaped like spheres and are destoryed prematurely leading to anemia.
what is the most common congenital anomaly of the spleen? Where are they most commonly found?
splenunculus or accessory spleens (up to 30 percent of patients.) Most commonly found in the hilum.
Portal hypertension, congestion, neoplasm, storage disease, infection, anemia, and trauma are all causes of what disease?,
splenomegaly
What is splenic congestion and what is it caused by?
blood flow out of the spleen is blocked. Caused by Portal HTN, thrombosis, heart failure, cystic fibrosis
What is Amyloid?
an abnormal protein usually produced by cells in the bone marrow that can be deposited in any tissue or organ
What is Amyloidosis? How might it appear sonographically?
Buildup of amyloid proteins in an organ. The spleen may be normal or enlarged depending on the
amount of amyloid
What is the difference between nodular and diffuse Amyloidosis?
Nodular: Amyloid is found in walls of arteries and follicles.
Diffuse: Amyloid is found in Red pulp and spleen is large and firm.
What is Gaucher disease? What are symptoms?
Gaucher disease is an abnormal storage of proteins and far. Symptoms include bone pain and skin pigmentation changes.
Who is affected by Gaucher disease?
50% of patients are under 8 and 17% are under 1 year.
How does Gaucher disease appear sonographically?
splenomegaly, splenic nodules, complex
What is Niemann-Pick disease and who does it most commonly affect?
It is a rapidly fatal disease that causes the abnormal storage of fat. It typically affects female infants.
What symptoms is Niemann-Pick associated with?
digestive issues, hepatomegaly, and hyphadenopathy
What is sickle cell anemia? What demographic is most common
Sickle shaped RBCs get stuck in blood vessels which slows or blocks blood travel and oxygen. It more commonly affects black populations
How does sickle cell anemia appear sonographically?
Acute SCA appears In children as splenomegaly and a decreased hematocrit. It may develop hemorrhage in the periphery.
What are the results of congenital spherocytosis?
Production by the bone marrow of spherocytic erythrocytes or increased destruction of these cells in the spleen.
What is hemolytic anemia?
Premature destruction of red blood cells. It can occur without other disease or secondary to other reticuloendothelial diseases.
What is polycythemia vera?
A chronic disease with unknown cause involving bone marrow elements. An increase in red blood cell and hemoglobin concentration.
How might polycythemia vera appear sonographically?
Enlarged, firm, and with thrombosis or infarctions.
What is thalassemia?
Short-lived RBCs because the spleen destroys them in large numbers. It appears as a massive spleen.
