Spleen Flashcards

1
Q

Where are splenules most commonly found?

A

Splenic hilum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is a splenule?

A

focus of normal splenic tissue separate from the the main body of the spleen. Due to embryologic failure of fusion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Heterotaxy syndrome with multiple foci of splenic tissue

A

Polysplenia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Polysplenia is associated with:

A

cardiac abnormalities heterotaxy venous anomalies including interruption of the IVC with azygos or hemiazygos continuation Pre-duodenal portal vein

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Pre-duodenal vein is associated with what condition

A

polysplenia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

How does a wandering spleen typically present?

A

abdominal mass pain (secondary to torsion)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Abnormal laxity or absence of the fixed splenic ligamentous attachments is often referred to as a:

A

wandering spleen the laxity of the ligaments results in torsion or abnormal movement of the spleen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Most common benign splenic neoplasm:

A

hemangioma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Splenic hemangiomas are associated with

A

Kasabach-Merrit syndrome (anemia, thrombocytopenia, consumptive coagulopathy) and Kippel Trenaunay Weber syndrome (cutaneous hemangiomas varicose veins, and extremity hypertrophy)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What splenic finding is associated with Kasabach-Merrit syndome?

A

splenic hemangiomas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What splenic finding is associated with Kippel-Trenaunay-Weber syndome?

A

splenic hemangiomas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

With visceral hemangiomatosis syndromes, what imaging characteristic is associated with splenic hemangiomas?

A

phleboliths

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

MRI characteristics of splenic hemangiomas

A

T2 bight enhancement peripherally or homogenously

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Splenic hamartomas are associated with:

A

TSC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What markers are increased in patients with true splenic cysts?

A

CA19-9, CA125, CEA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Most splenic cysts are acquired or congenital?

A

acquired

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

possible intrasplenic finding in a patient with pancreatitis?

A

intrasplenic pseudocyst

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Classic imaging appearance of splenic lymphangioma:

A

single or multiple multilocular cystic structure with thin septations with septal enhancement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

single or multiple multilocular cystic structure with thin septations with septal enhancement

A

Splenic lymphangioma cysts and pseudocyts are typically unilocular

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

spleen in sarcoidosis

A

If spleen is involved in sarcoid, will see splenomegaly and hepatomegaly less commonly numerous hypoattenuating 1-3cm lesions without enhancement (noncaseating granulomas)

21
Q

rare focal collection of immune cells and associated inflammatory exudate, of unclear etiology. Patients often have constitutional symptoms including fever and malaise.

A

Inflammatory pseudotumor

22
Q

What is an inflammatory pseudotumor?

A

rare focal collection of immune cells and associated inflammatory exudate, of unclear etiology. Patients often have constitutional symptoms including fever and malaise.

23
Q

Single splenic abscess more likely to be:

A

bacterial

24
Q

Multiple splenic abscesses are more likely to be:

A

fungal

25
Q

Wheel within a wheel/ bull’s eye appearance on US:

A

Splenic abscess describes concentric hyperechoic and hypoechoic rings surrounding the abscess

26
Q

treatment for splenic abscess

A

CT or US guided percutaneous drainage + ABX

27
Q

Immunocompromised pt with fever and multiple small <1cm splenic foci

A

fungal splenic abscesses

28
Q

Most common fungi to cause splenic abscesses

A

candida, aspergillus, cryptococcus

29
Q

Multiple calcified splenic nodules in an AIDS patient

A

pneumocystits jiroveci

30
Q

Splenic cyst with internal undulating membrane and daughter cysts

A

echinococcal cyst splenic involvement is seen in only 1-3% of cases

31
Q

Most common splenic malignancy

A

lymphoma

32
Q

Is primary or secondary lymphoma more common?

A

secondary

33
Q

US appearance of splenic lymphoma

A

cyst like (due to homogeneity of structure without interfaces) But with show internal flow

34
Q

Most common primary tumors to metastasize to the spleen:

A

breast lung ovarian melanoma

35
Q

Which cancers commonly cause cystic mets in the spleen?

A

ovarian melanoma

36
Q

Very aggressive primary malignancy of the spleen

A

angiosarcoma presents as enlarged heterogenous mass that may completely replace normal spleen.

37
Q

Chronic splenic infarct MR appearance

A

T1 dark T2 bright

38
Q

What are gamma gandy bodies?

A

multiple tiny foci of hemosiderin from portal hypertension

39
Q

Splenic manifestations of Gaucher disease

A

splenomegaly multiple splenic nodules (seen in one third of Gaucher patients)

40
Q

Phase of contrast needed to evaluate splenic injury:

A

portal venous

41
Q

Most widely accepted splenic injury grading system:

A

MDCT

42
Q

MDCT grade 1 injury

A

small <1cm subcapsular hematoma, laceration or parenchymal hematoma

43
Q

MDCT grade 2 injury

A

medium (>1 and < 3 cm) subcapsular hematoma, laceration or parenchymal hematoma

44
Q

MDCT grade 3 injury

A

splenic capsular disruption or large (>3cm) laceration or parenchymal hematoma

45
Q

MDCT grade 4a injury

A

active exstravasation vascular injury (pseudoaneurysm or AV fistula) shattered spleen

46
Q

MDCT grade 4b

A

active intraperitoneal bleeding

47
Q
A

ploysplenia

48
Q
A