GI Section VIII: Spleen Flashcards

1
Q

spleen reaches its normal adult size by the age of?

A

15

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2
Q

The spleen

A

Contains Red and White pulps
Red pulp = blood
20 HU less dense than the liver
More echogenic than the liver

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3
Q

The splenic artery arises from?

A

The celiac trunk

Essentially an end vessel with minimal collaterals

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4
Q

Pathology involving the spleen can be categorized as

A

Congenital
Aquired (trauma - portal HTN)
Mass

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5
Q

Normal Spleen on MRI

A
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6
Q

The spleen is basically a?

A

a big watery lymph node.

It restricts diffusion (like a lymph node).

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7
Q

Accessory Spleens (Splenule):

A
  • Can mimic a pancreatic tail mass or a bad lymph node
  • They will often follow the spleen on different CT contrast phases
  • hey can hypertrophy
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8
Q

Cause of splenic hypertrophy

A

POst splenectomy
ITP
AHA

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9
Q

a wandering spleen is associated with

A

abnormalities of intestinal rotation.

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10
Q

The other key piece of trivia is that unusual locations set the spleen up for

A

torsion and subsequent infarction

A chronic partial torsion can lead to gastric varices.

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11
Q

the most common solid organ injured in trauma

A

Spleen

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12
Q

occurs post trauma where a smashed spleen implants and then recruits blood supply.

A

Splenosis

If the diaphragm has been ruptured - they can be pleural based nodules.

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13
Q

What can confirm that the implants are splenosis?

A

Tc Sulfur colloid (or heat-treated RBC)

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14
Q

Absent spleen + lots of soft tissue masses + Hx of trauma =

A

Think splenosis

if you think mets, check and make sure the spleen is normal.

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15
Q

These are small foci of hemorrhage in the splenic parenchyma that are usually associated with portal hypertension. They are T2 dark.

A

Gamna Gandy Bodies (Siderotic Module):

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16
Q
A

Gamna Gandy Bodies (Siderotic Module)

Gradient is the most sensitive sequence.

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17
Q

his is a rare condition characterized by multiple blood filled cyst-like spaces in a solid organ

A

Peliosis

18
Q

most common visceral arterial aneurysm.

A

Splenic artery aneurysm

19
Q

Pseudoaneurysm can occur in the setting of

A

Trauma and pancreatitis

20
Q

The incidence is higher in women of

A

child bearing age who have had two or more pregnancies {4x more likely to get them, 3x more likely to rupture).

21
Q

Splenic Artery Aneurysm are usually

A

Saccular and in the mid-distal artery

Don’t call them a hypervascular pancreatic islet cell mass and biopsy them.

22
Q

frequently occurs as the result of pancreatitis. Can also occur in the setting of diverticulitis or Crohn’s.

Can lead to isolated gastric varices.

A

Splenic Vein Thrombosis

23
Q

Infarction imaging features

A

a wedge-shaped, peripheral, low attenuation defect.

24
Q

Most common radiologically detected splenic infection

A

histoplasmosis (with multiple round calcifications)

25
Q

Another possible cause of calcified granuloma in the spleen

A

brucellosis

Solitary
> 2cm

26
Q
A

SPleni abscess by brucillosis

a low density center, encircled by calcification giving the lesion a “bull’s eye” appearance.

27
Q

Felty’s Syndrome

A

abnormality of granulocytes, with a triad:

(1) Splenomegaly, ^
(2) Rheumatoid Arthritis,
(3) Neutropenia

28
Q

the most common cystic lesion in the spleen

A

Post traumatic cysts (pseudocysts)

Secondary to:
Infection
Infarction
Hemorrhage
Extension from pancreatic pseudocyst

PSeudo = no epithelial linging

29
Q

the second most common cystic lesion in the spleen

A

Epidermoid cysts

Congenital

30
Q

the third most common cystic lesion in the spleen.

A

Hydatid or Echinococcal cysts

31
Q
A

Hydatid or Echinococcal cysts

32
Q

the most common benign neoplasm in the spleen

A

Hemangioma

33
Q

Splenic lymphangiomas

A

RAre

Most occur in childhood
MAy be solitary/multiple in a subscapular
Diffuse lymphangiomas may occur

34
Q

hyperdense if there is hemosiderin deposition.

A

Hamartomas

35
Q
A

Littoral Cell Angioma

hypoattenuating on late portal phase

MRI: hemosidering (low T1 and T2)

36
Q

it is highly unlikely that you will encounter a primary malignancy of the spleen

but ifyou do it’s likely to be?

A

Vascular

37
Q

The most common malignancy in the spleen

A

Angiosarcoma

38
Q
A

Angiosarcoma

39
Q

poorly defined area of heterogenicity or low density in an enlarged spleen

A

Angiosarcoma

40
Q

can occur from prior thorotrast exposure.

A

SPlenic angiosarcoma

41
Q

the most common primary neoplasm that mets to the spleen.

A

Melanoma