Pathology of the Spleen

Question 1

What organ contains the largest single collection of lymphocytes and reticuloendothelial (RE) cells

Answer 1

Spleen

Question 2

What is the average weight of the spleen

Answer 2

100-150g

Question 3

Where is the Spleen located

Answer 3

Under the diaphragm, In the Upper left quandrant

Question 4

What is the function of the spleen

Answer 4

Filtration of blood
Foreign matter pitting (cause swelling)
Culling damage cells (Reducing)
Humoral and Cellular Immune Function

Question 5

Where are Lymphoid cells located

Answer 5

White pulp

Question 6

What is the term used to describe the enlargement of the spleen

Answer 6

Splenomegaly

Question 7

What are the functional disorders of the immune system

Answer 7

Alterations of Immune System

Alterations of Haematopoiesis

Question 8

What 4 cells causes an increase in filtration

Answer 8

Abnormal RBC’s
Abnormal RBC inclusions (eg malaria)
Abnormal particulate matter (bacteria, cell debris)
Abnormal macromolecules

Question 9

What are the causes of Splenomegaly

Answer 9

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

Question 10

In terms of congestive states, What is the cause of Congestive Splenomegaly

Answer 10

Portal Hypertension:
Cirrhosis of the liver
Right heart failure
Portal / splenic vein thrombosis

Question 11

What is the morphology of congestive Splenomegaly

Answer 11

Marked enlargement

Firm (cricket ball)

Question 12

What is the histology of congestive splenomegaly

Answer 12

Fibrosis
± Infarcts
± Fibrosiderotic nodules (Gamna-Gandy bodies)
± Extramedullary haematopoiesis

Question 13

What is the cause of Haematogenous Disorders in the spleen

Answer 13

Haematogenous Disorders

Sickle Cell Disease

Question 14

What are the early signs of Haematogenous Disorders in sickle cell anaemia

Answer 14

Congestion of splenic cords
Repeated haemorrhagic infarction
Depressed scars
Gamna-Gandy bodies

Question 15

What are the signs of Haematogenous Disorders in sickle cell anaemia

Answer 15

Autosplenectomy (infarction)

Persists in HbSC disease

Question 16

What are the childhood signs of Haematogenous Disorders in sickle cell anaemia

Answer 16

• Sequestration

Question 17

What are the infectious causes of Splenomegaly

Answer 17

TB
Malaria
Infectious Mononucleosis
Epstein Barr Virus (EBV)
Typhoid, CMV, HIV

Question 18

What are the non-specific cause of Splenomegaly

Answer 18

Septicaemia

Question 19

What is the morphology of Infectious Splenomegaly

Answer 19

Moderate enlargement
Congested
Soft, semi-liquid or diffluent (mushy)

Question 20

What is the Histology of infectious splenomegaly

Answer 20

± Organisms
RE hyperplasia
Erythrophagocytosis (typhoid)
Mononucleosis (atypical) cells 
Necrosis, polymorphs, eosinophils

Question 21

What are the causes of Primary Neoplasms in the spleen

Answer 21

Lymphomas/Leukaemias
Soft tissue tumours
± Haemangiomas
± Lymphangiomas

Question 22

What are the causes of Secondary Neoplasms in the spleen

Answer 22

GIT

Question 23

What are some autoimmune diseases that causes splenomegaly

Answer 23

Rheumatoid arthritis (RA)
Systemic lupus erythematosus (SLE)
Sarcoidosis
Amyloidosis

Question 24

What is the morphology of autoimmune splenomegaly

Answer 24

moderate - marked enlargement

prominent white pulp

Question 25

What is the histology of autoimmune splenomegaly

Answer 25

Hyperplasia of white pulp Sarcoidosis: Granulomas

Question 26

What causes Lysosomal Storage Diseases in the spleen

Answer 26

(n-born errors of metabolism ~50 rare inherited metabolic disorders Lysosomal enzyme defects Macromolecules accumulate within cells

Question 27

What diseases causes storage diseases splenomegaly

Answer 27

``` (In-born errors of metabolism) Gaucher (sphingolipids) Mucopolysaccharidoses Niemann-Pick (Lipids) RE cell hyperplasia ```

Question 28

What causes Massive splenomegaly

Answer 28

Chronic Myeloid leukaemia Myelofibrosis Malaria

Question 29

What are 2 miscellaneous causes of Splenomegaly

Answer 29

Infarction | Cysts

Question 30

True or False, In Splenic infarcts there is a mild enlargement in the acute stage

Answer 30

True

Question 31

What are the causes of | Splenic Infarcts

Answer 31

Embolic occlusion of splenic artery

Question 32

What is the gross anatomy of splenic infarcts

Answer 32

Pale, wedge-shaped | + suppurative necrosis with septic emboli

Question 33

What is the healed anatomy of splenic infarcts

Answer 33

Fibrous scars

Question 34

What is the cause of parasitic splenic cysts

Answer 34

Echinococcus (dog tape worm- Hydatid cysts)

Question 35

True or False, Splenic Cysts are rare

Answer 35

True

Question 36

What is the cause of nonparasitic splenic cysts

Answer 36

``` True cysts - epithelial lining -Epidermoid -Dermoid Pseudo-cysts - fibrous tissue lining -Due to trauma -Haemorrhage and organization ```

Question 37

What is the cause of splenic rupture

Answer 37

Usually Traumatic

Question 38

What is the cause of spontaneous splenic rupture

Answer 38

typhoid, malaria, infectious mono

Question 39

What is the cause of Rx splenectomy

Answer 39

More severe infections with capsulated organisms