Chapter 6: Spleen Flashcards
The spleen _________ in size with age
Decreases
The spleen is the ________ lymphatic organ
Largest
Describe extramedullary hematopoiesis
When the spleen takes over the bone marrow and starts producing RBCs in cases of severe anemia
What is the function of the white pulp
Carries out the spleen’s lymphatic function
(Produces and houses lymphocytes)
What is the function of the red pulp
Performs phagotic function of the spleen
Contains RBCs and macrophages
What is culling
Removal of irregular RBC’s
What is pitting
Removal of unwanted material from RBCs
The splenic artery enters the hilum ______ to the splenic vein
Anterior
The splenic artery has a _____ resistance flow
Low
What are other names for an accessory spleen
Splenule
Splenunculus
Supernumerary
What is a splenic cleft
Spleen appears to be divided by a hyperechoic line
Asplenia and polysplenia have been associated with ______ malformations and abnormal location of other organs
Cardiac
With a wandering spleen, pt could suffer from what
Splenic torsion
Whats the name for leukocytes found within the spleen
Lymphocytes
With splenomegaly, the spleen tends to become __________ as it enlarges
Hypoechoic
What is the most common cause of splenomegaly
Portal hypertension
Epstein- Barr infection (mononucleosis) will always result in _______
Splenomegaly
For it to be considered splenomegaly, the spleen should exceed ______ cm length, and ___ cm thickness
12-3cm,
6cm
With splenomegaly, the spleen extends beyond the ______ pole of the kidney
Inferior
What are clinical findings related to splenomegaly
Palpable enlarged spleen, LUQ pain, leukocytosis, infection, trauma, cirrhosis, leukemia, lymphoma, sickle cell anemia
Splenic cysts are also called _______cysts
Epithelial
Splenic cysts can also be associated with
Autosomal dominant polycystic kidney disease
What are the symptoms of splenic cysts
Asymptomatic
Pain can occur with hemorrhage
A splenic hydatid cyst is caused by what
The tapeworm Echinococcus granulosus
Fungal splenic abscesses often result from _______
Cándida
A history of bacteremia, increases the risk of developing ______
Splenic abscesses
What are the clinical findings of splenic abscesses
Fever
Leukocytosis
LUQ pain
Lt flank or shoulder pain
Splenomegaly
What are the sonographic findings of a splenic abscess
Fungal abscess may appear as a bulls eye
Increased vascularity around mass but not within it
May contain debris or gas
Describe a splenic infarct
Tissue has been deprived of oxygen and died
What are the symptoms of splenic infarct
Sudden onset of LUQ pain
What does an acute splenic infarct look like
Hypoechoic wedge shaped mass
What does a chronic splenic infarct look like
Hyperechoic wedge shaped mass
What are the clinical findings of splenic trauma
Blunt trauma to LUQ
LUQ pain
Low hematocrit
What does a splenic trauma look like on ultrasound
Acute hemorrhage (complex or hypoechoic)
Will look different depending on age of the hemorrhage
What is a splenic hemangioma
Most common benign asymptomatic tumor of the spleen
Hyperechoic mass
What is granulomatous disease
Asymptomatic small echogenic foci (granuloma) that may shadow
A pt with granulomatous may have a history of what three diseases
Histoplasmosis
Tuberculosis
Sarcoidosis
What is a splenic hamartoma
Benign hypoechoic mass or masses
Color Doppler may show hypervascularity
What are the clinical findings of splenic hamartoma
Asymptomatic (pain may occur with rupture)
Hx of Beckwith-Wideman syndrome or Tuberus sclerosis
What is the primary malignant tumor of the spleen
Angiosarcoma
More often lymphoma and leukemia will involve the ____
Spleen
Focal masses are less common with ________
Leukemia
Describe hodgkin lymphoma
Malignant
Presence of Reed-Sternberg cells
High recovery rate
Describe non-hodgkin lymphoma
Malignant
Not as easily managed
More common
What are the clinical findings of spleen malignancies
LUQ pain
Fever
Weight loss
Malaise
What does spleen malignancies look like on ultrasound
Diffuse - splenomegaly
Focal - hypoechoic masses
What is sickle cell disease
Group of inherited blood disorders that affect the hemoglobin
What are sickle cell anemia symptoms
Low hematocrit
Bone pain
Autosplenectomy may occur with sickle cell anemia, what does that refer to
Spontaneous splenic infarction
With sickle cell anemia, abnormal ________ - shaped RBS tend to attach to each other and obstruct vascular channels
Crescent
What are the sonographic findings of sickle cell anemia
Enlarged spleen during a crisis
Focal masses of normal splenic tissue
With time, spleen will look fibrotic and atrophy
What is a splenic lymphangioma
Benign lesion that is a congenital malformation of the lymphatic system
A lymphangioma is comprised of lymphatic tissue and ________
Blood vessels
What do lymphangiomas look like
Multicystic masses with hypoechoic or anechoic locules and hyperechoic septations
What are the symptoms of splenic lymphangioma
Náusea
LUQ pain
Abdominal distention
Splenomegaly
What is the gold standard imaging for the spleen
CT
