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Abdomen Pathology > Spleen > Flashcards

Spleen Flashcards

1
Q

Location of the spleen

A

LUQ, intraperitoneal

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2
Q

size of spleen (adult)

A

12 cm or less - longitudinal length
less than 8 cm - AP
less than 4 cm - wide, TRV

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3
Q

arterial blood supply of spleen

A

splenic artery - from celiac trunk/axis

courses along the superior pancreatic border to the hilum

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4
Q

venous system of spleen

A

splenic vein - joins with the superior mesenteric vein and forms the main portal vein
-splenic vein is located inferior and posterior to the pancreas body

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5
Q

4 normal spleen variants and their definition

A
  1. aplasia - spleen did not develop
  2. hypoplasia - defective development of tissue (under development)
  3. accessory spleen - aka: supernumerary spleen, splenunculus - ectopic splenic tissue
  4. wandering spleen - fusion failure of the dorsal mesentery with the posterior peritoneum
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6
Q

functions of spleen

A

filters blood
reservoir for blood
destroys red blood cells
produces lymphocytes and plasma cells

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7
Q

job of red pulp

A

stores rbcs, filtration

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8
Q

what is congestive splenomegaly and what are some causes

A

enlargement of spleen, increased amount of red pulp

causes: heart failure, cirrhosis, portal hypertension, portal/splenic vein thrombosis, cystic fibrosis, HIV/AIDS

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9
Q

clinical presentations of congestive splenomegaly

A 
LUQ pain
congestion/edema in lower extremities
increased abdominal girth - ascites
caput medusa - portal hypertension 
hepatomegaly
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10
Q

types of systemic infection/inflammation

A 
mononucleosis
tuberculosis
histoplasmosis
schistosomiasis
sarcoidosis
candidiasis
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11
Q

types of focal infection/inflammtion

A

parasitic - echinococcus

abscess

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12
Q

echinococcus infection of spleen

A

s/s: LUQ pain. fever, elevated wbcs

  • focal/solitary cyst with or without daughter cyst
  • hydatid sand with or without infolded membranes
  • egg-shell calcifiction of borders
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13
Q

abscess infection/inflammation of spleen

A

s/s: LUQ pain, fever, elevated wbcs

  • ill-defined, thickened, irregular borders
  • acoustic enhancment is possible
  • shadowing with intraluminal gas
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14
Q

treatment options for infection/inflammation of spleen

A 
antiobiotic therapy
percutaneous drainage with or without scolecoidal therapy
surgical resection 
anthelmintic drug therapy 
high mortalilty rate with abscesses
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15
Q

what is a splenic hamartoma

A 
benign
rare
solitary
non-neoplastic, congenital mass
composed of: normal splenic elements
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16
Q

another name for splenic hamartoma

A

splenoma

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17
Q

sonographic findings of splenomas

A

focal well-defined mass

variable echogenicity

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18
Q

what is a splenic hemangioma

A

congenital mass
benign
composed of vascular epithelial lined channels

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19
Q

what is the most common primary splenic tumor? and what is its incidence?

A

splenic hemangioma

more frequent in males, 20-50 years old

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20
Q

s/s of splenic hemangioma

A

asymptomatic

LUQ pain and fullness

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21
Q

sonographic findings of splenic hemangioma

A

less than 4cm
well defined borders
from hyperechoic to complex with areas of cystic degeneration
may contain foci of speckled calcifications

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22
Q

what is luekemia

A

primary malignancy of the blood-forming tissues characterized by an abnoromal increase in the WBCs

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23
Q

what are some blood-forming tissues

A

bone marrow
lymph nodes
spleen

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24
Q

luekemia is more common in

A

males

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25
Q

s/s of leukemia

A 
easily bruises or bleeds
pallor - pale in color
fatigue
recurrent infection
non healing minor wounds
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26
Q

lab findings for leukemia

A

increased WBCs and anemia

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27
Q

a patient with leukemia comes in for an ultrasound - their spleen would look

A

enlarged - splenomegaly

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28
Q

what is lymphoma

A

primary malignancy of the lymphatic system

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29
Q

s/s of lymphoma

A 
asymptomatic node enlargement
**cervical, supraclavicular, axillary, inguinal
low grade fever
night sweats
fatigue
weight loss
coughing 
abnormal pressure and congestion of face, neck and chest
30
Q

sonographic findings of lymphoma

A

focal mass
hypoechoic
poorly defined margins
diffuse splenomegaly

31
Q

what is another name for hemangiosarcoma

A

splenic angiosarcoma

32
Q

incidence and outcome of angiosarcoma

A

very rare
50-60 years of age

poor prognosis - 80% mortality rate within 6 months of dx

33
Q

lab findings for angiosarcoma

A

anemia

thrombocytopenia

34
Q

s/s of angiosarcoma

A 
abdominal mass
LUQ pain
fatigue
fever
weight loss
GI bleeding
35
Q

sonographical findings of angiosarcoma/hemangiosarcoma

A

splenomegaly
solitary, complex mass
multiple nodules of vaying size

36
Q

what are true cyst

A

congenital cyst

have an epithelial or endothelial lining

37
Q

true cyst are also called

A

epidermoid cyst

congenital cyst

38
Q

true cyst are usually unilocular or multilocular

A

unilocular

39
Q

post traumatic cyst

  • aka
  • incidence
A

aka Splenic pseudocyst
accounts for 80% of all splenic cyst
DOES NOT HAVE epithelial lining

40
Q

3 infectious cyst

A

abscess
granulomatous
pneumocystis carinii

41
Q

splenic cyst may sonographically appear as

A 
anechoic, hypoechoic
well defined walls
posterior enhancement 
internal echoes
fluid-fluid level
wall thickening
wall califications
42
Q

types of blood disorders

A

hemolytic anemia
extramedullary hematopoiesis
sickle cell anemia
polycythemia vera

43
Q

what is hemolytic anemia

A

disorder in which rbcs are destroyed faster than they are being produced

44
Q

what is extramedullary hematopoiesis

A

where the production of RBCs and platelets occurs outside the bone marrow

45
Q

myelofibrosis is cancer of the bone marrow. What are some of its clinical associations

A

anemia
splenomegaly
extramedullary hematopoiesis
progressive fibrosis of bone marrow

46
Q

what is sicke cell anemia and what does it cause?

A

a genetic mutation in African Americans which causes the RBC to have an altered shape and plasticity

47
Q

what does sickle cell anemia lead to

A 
increased blood viscosity 
stasis
small vessel occlusion
infarction 
necrosis
48
Q

if a child has sickle cell anemia, how will their spleen be as children compared to as an adult

A

as a child - splenomegaly

as an adult - atrophic spleen

49
Q

what does chronic hemolytic anemia lead to

A

jaundice

50
Q

what is polythemia vera

A

an acquired myeloproliferative disorder

the bone marrow produces too much RBCS, WBCS and platelets

51
Q

what does polythemia vera cause

A 
increase in blood viscosity 
poor profusion 
elevated hematocrit, rbcs and hemoglobin
decreased oxygen saturation of blood
splenomegaly
thrombosis
52
Q

types of storage diseases

A 
Gaucher disease
Diabetes mellitus
Niemann - Pick disease
Amyloidosis
Histiocytosis
Hemochromatosis
53
Q

What is Gaucher disease?
Who does it most commonly affect?
s/s
sonographic findings

A
  • genetic disorder
  • children under 8 yrs
  • bone pain and skin pigmentation
  • splenomegaly, diffuse inhomogeneous nodular texture, fibrosis and infarction
54
Q

storage disease - diabetes mellitus

A

vascular infarcts secondary to diabetes iniced small vessel atherosclerotic diease

55
Q

what is Niemann-Pick disease

A

a fatal storage disease
affects female infants
hepatomegaly, digestive issues, lymphadenopathy

56
Q

what is amyloidosis

A

systemic abnormal amyloid distribuition
nodular and diffuse
splenomegaly

57
Q

what is Histiocyosis

A

fatal thrombocytopenia associated with hypersplenism (excessive removal of cellular blood components)
splenomegaly

58
Q

what is hemochromatosis

A

excessive absorption and storage of iron = organ damage

iron deposits typically in liver = cirrhosis = portal hypertension and splenomegaly

59
Q

what is infarction

A

when the blood supply to the area is compromised = ischemia and then necrosis

60
Q

most common cause of foccal splenic defects

A

infarction

61
Q

hypovolemic shock is a clinical presentation of what

A

truama to the spleen, blunt ot penetrating force

62
Q

the spleen is the most frequently intraperitoneal organ in blunt abdominal trauma
T or F

A

true

63
Q

sonographic findings of trauma

A
  • hematoma (subcapsular or intraparencymal)
  • hemoperitoneum or hemoretroperitoneum with capsular rupture
  • depending on age and progression
  • *earlystage - anechoic to hypoechoic
  • *later stage - echogenic bledding with splenic parenchyma
  • left pleural effusion
64
Q

what is asplenia syndrome - what is is associated with

A

congenital abscene of spleen

-associated with bilateral right sideness

65
Q

what is polysplenia syndrome

A

multiple islands of splenic tissue

-may have bilateral left-sidedness

66
Q

which has these sonographic appearences

  • biliary atresia
  • genitourinary anomalies
  • abnormal liver location
  • azygous/hemiazygous continuation of IVC with interruption of hepatic segment
A

polysplenia syndrome

67
Q

accessory spleens are most often located where

A

at the hilum

68
Q

the sonographic appearance of the spleen in relationship to liver

A

isoechoic or hyperechoic and homogeneous

69
Q

the most common focal neoplasm in the spleen is what

A

a cavernous hemangioma

70
Q

risk factors for splenic infarction

A 
bacterial endocarditis
atherosclerosis
sickle cell disease
polycythemia
splenomegaly
gaucher disease
portal hypertension
vascular compromise of splenic artery

Abdomen Pathology (1 decks)

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