Pathology of the Spleen Flashcards
What organ contains the largest single collection of lymphocytes and reticuloendothelial (RE) cells
Spleen
What is the average weight of the spleen
100-150g
Where is the Spleen located
Under the diaphragm, In the Upper left quandrant
What is the function of the spleen
Filtration of blood
Foreign matter pitting (cause swelling)
Culling damage cells (Reducing)
Humoral and Cellular Immune Function
Where are Lymphoid cells located
White pulp
What is the term used to describe the enlargement of the spleen
Splenomegaly
What are the functional disorders of the immune system
Alterations of Immune System
Alterations of Haematopoiesis
What 4 cells causes an increase in filtration
Abnormal RBC’s
Abnormal RBC inclusions (eg malaria)
Abnormal particulate matter (bacteria, cell debris)
Abnormal macromolecules
What are the causes of Splenomegaly
CHINAS
Congestion – portal hypertension
Haematological – haemolytic anaemia, sickle cell disease
Infection – malaria, TB, EBV, CMV, HIV
Neoplasm – CML, myelofibrosis, lymphoma
Autoimmune – RA, sarcoidosis, amyloidosis
Storage disorders
In terms of congestive states, What is the cause of Congestive Splenomegaly
Portal Hypertension:
Cirrhosis of the liver
Right heart failure
Portal / splenic vein thrombosis
What is the morphology of congestive Splenomegaly
Marked enlargement
Firm (cricket ball)
What is the histology of congestive splenomegaly
Fibrosis
± Infarcts
± Fibrosiderotic nodules (Gamna-Gandy bodies)
± Extramedullary haematopoiesis
What is the cause of Haematogenous Disorders in the spleen
Haematogenous Disorders
Sickle Cell Disease
What are the early signs of Haematogenous Disorders in sickle cell anaemia
Congestion of splenic cords
Repeated haemorrhagic infarction
Depressed scars
Gamna-Gandy bodies
What are the signs of Haematogenous Disorders in sickle cell anaemia
Autosplenectomy (infarction)
Persists in HbSC disease
What are the childhood signs of Haematogenous Disorders in sickle cell anaemia
- Sequestration
What are the infectious causes of Splenomegaly
TB Malaria Infectious Mononucleosis Epstein Barr Virus (EBV) Typhoid, CMV, HIV
What are the non-specific cause of Splenomegaly
Septicaemia
What is the morphology of Infectious Splenomegaly
Moderate enlargement
Congested
Soft, semi-liquid or diffluent (mushy)
What is the Histology of infectious splenomegaly
± Organisms RE hyperplasia Erythrophagocytosis (typhoid) Mononucleosis (atypical) cells Necrosis, polymorphs, eosinophils
What are the causes of Primary Neoplasms in the spleen
Lymphomas/Leukaemias
Soft tissue tumours
± Haemangiomas
± Lymphangiomas
What are the causes of Secondary Neoplasms in the spleen
GIT
What are some autoimmune diseases that causes splenomegaly
Rheumatoid arthritis (RA) Systemic lupus erythematosus (SLE) Sarcoidosis Amyloidosis
What is the morphology of autoimmune splenomegaly
moderate - marked enlargement
prominent white pulp
What is the histology of autoimmune splenomegaly
Hyperplasia of white pulp
Sarcoidosis:
Granulomas
What causes Lysosomal Storage Diseases in the spleen
(n-born errors of metabolism
~50 rare inherited metabolic disorders
Lysosomal enzyme defects
Macromolecules accumulate within cells
What diseases causes storage diseases splenomegaly
(In-born errors of metabolism) Gaucher (sphingolipids) Mucopolysaccharidoses Niemann-Pick (Lipids) RE cell hyperplasia
What causes Massive splenomegaly
Chronic Myeloid leukaemia
Myelofibrosis
Malaria
What are 2 miscellaneous causes of Splenomegaly
Infarction
Cysts
True or False, In Splenic infarcts there is a mild enlargement in the acute stage
True
What are the causes of
Splenic Infarcts
Embolic occlusion of splenic artery
What is the gross anatomy of splenic infarcts
Pale, wedge-shaped
+ suppurative necrosis with septic emboli
What is the healed anatomy of splenic infarcts
Fibrous scars
What is the cause of parasitic splenic cysts
Echinococcus (dog tape worm- Hydatid cysts)
True or False, Splenic Cysts are rare
True
What is the cause of nonparasitic splenic cysts
True cysts - epithelial lining -Epidermoid -Dermoid Pseudo-cysts - fibrous tissue lining -Due to trauma -Haemorrhage and organization
What is the cause of splenic rupture
Usually Traumatic
What is the cause of spontaneous splenic rupture
typhoid, malaria, infectious mono
What is the cause of Rx splenectomy
More severe infections with capsulated organisms
