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BOD 3 Exam 1 > Spleen > Flashcards

Spleen Flashcards

1
Q

is the spleen on the right or left side of the body?

A

left
left cranial hypogastric region

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2
Q

describe the spleen structure

A

thick capsule: smooth muscle, elastic fibers, fibromuscular trabeculae extend into parenchyma
smooth muscle allows for contraction

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3
Q

what are the 2 components of the spleen?

A

red pulp and white pulp

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4
Q

what does the red pulp contain?

A
  • red blood cells: sinusoidal vs non-sinusoidal
  • monocytes/macrophages
  • stromal elements: reticular cells, fibroblasts, myocytes
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5
Q

what species have sinusoidal red blood cells in the red pulp of the spleen?

A

dogs, rats, humans

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6
Q

what does the white pulp contain?

A
  • PALs: periarteriolar lymphoid sheaths: T cells that wrap around the central arteriole
  • splenic follicle: B cells
  • marginal zone: antigen presenting cells (macrophages, B cells), and T cells
  • germinal center: transient (don’t see all the time), depends on immune state of the animal
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7
Q

what are periarteriolar lymphoid sheaths?

A

part of the white pulp of the spleen, contain T cells and wrap around the central arteriole

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8
Q

how does blood flow into the spleen?

A

splenic artery
fibromuscular trabeculae
trabecular arteries become central arteries
central arteries branch to supply the marginal sinus
leaves white pulp
enters red pulp as penicillar arterioles
drains into sinusoids
empties into splenic venules
splenic veins
portal vein
liver

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9
Q

how does splenic blood get to the liver (simplified)

A

splenic artery into spleen
leaves white pulp and goes into red pulp
drains into splenic venules, then splenic veins
portal vein
liver

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10
Q

what are the 3 main functions of the spleen?

A
  1. sieve for circulating cells: filters/removes debris, senescent cells, bacteria
  2. secondary lymphoid organ: activates macrophages, proliferates B lymphs, interaction of T lymphs and antigens
  3. storage of blood (dog, cat, horse)
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11
Q

in what species does the spleen act as a storage of blood?

A

dogs, cats, horses

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12
Q

what are storage spleens?

A

splenic capsule/trabeculae with high percentage of smooth muscle and elastic fibers allowing the spleen to contract

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13
Q

what are defense spleens?

A

splenic capsule/trabeculae with low percentage of smooth muscle and elastic fibers

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14
Q

what species have storage and defensive spleens?

A

horses, cats, dogs

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15
Q

what species have intermediate (limited storage capacity) spleens?

A

pigs, ruminants

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16
Q

what species have defensive spleens?

A

rabbits, humans

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17
Q

what are possible distributions and consistencies of splenomegaly?

A

distribution: diffuse, nodular
consistency: soft (bloody), firm (Solid, meaty)

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18
Q

what are causes of diffuse splenomegaly?

A
  • splenic entrapment/volvulus/torsion
  • barbiturate euth, anesthesia, sedation
  • acute hyperemia and septicemia
  • acute hemolytic anemia
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19
Q

what are causes of nodular splenomegaly?

A
  • hematomas
  • hemorrhagic infarcts
  • neoplasia: hemangiosarcoma
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20
Q

hematomas, hemorrhagic infarcts and hemangiosarcomas are considered (diffuse/nodular) splenomegalies?

A

nodular

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21
Q

a dog presents with GDV. you remember from school that this can also come with what sequellae? how would you describe the look of the affected organ?

A

splenic entrapment
diffuse splenomegaly, soft/bloody/cavitated

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22
Q

a 2 year-old Jersey comes for necropsy after having died with no observable clinical signs. on physical exam, you note bleeding, bloating, and good BCS. you open the carcass and find diffuse, soft enlargement of the spleen. what do you do next and why?

A

STOP THE NECROPSY AND CLOSE THE ANIMAL
this is a case of ANTHRAX: if bacteria in circulation exceed capacity of the splenic macrophages, it can result in acute splenic congestion

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23
Q

Anthrax info

A

 Causative agent: Bacillus anthracis
 Large, gram-positive rods are found on blood or splenic smear
 Vegetative bacilli can be freed from an animal after death due to autolysis (bloating), scavengers or postmortem exam and the oxygen content of the air induces sporulation
 Spores are highly resident to temperature extremes, chemical disinfection and desiccation.
 The carcasses (bedding, feces other contaminated material) must be disposed
promptly by cremation or deep burial.
 Vaccinate exposed animals to contain and prevent disease

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24
Q

what is the course of disease of anthrax?

A
  • ruminants: peracute <2 hours hemorrhage, death
  • equids: acute/subacute <72 hr colic, enteritis
  • carnivores/omnivores: subacute/chronic >72 hr facial neck edema, GI, sepsis
25
pathogenesis of anthrax
- ingestion, inhalation or cutaneous (wound) of spores - endospores germinate: 1-14 days in macrophages - spread to lymph nodes --> systemic circulation - capsule, lethal and edema toxins: decreased phagocytosis, increased capillary permeability (edema) and delayed clotting (bleeding)
26
acute hyperemia (septicemia)
- ex: anthrax, salmonella, erysipelothrix - spleen mounts a strong response to blood-borne pathogens - if number of bacteria exceed capacity of spleen like in severe septicemia, may result in acute splenic congestion
27
what is acute hyperemia?
Acute hyperemia is a short-term increase in blood flow to a specific area of the body. It's a normal response to increased demand for blood and oxygen
28
what will cause diffuse "soft" enlargement of the spleen?
 Gastric volvulus with splenic entrapment  Splenic volvulus  Barbiturates (euthanasia, anesthesia, sedation)  Acute hyperemia (septicemia)  Examples: Anthrax, salmonella, erysipelothrix  Acute hemolytic anemia  Examples: babesiosis, hemolytic crises in equine infectious anemia, and immune-mediated hemolytic anemia
29
hematoma?
- bleeding into red pulp - red to dark red, soft bulging, usually solitary mass of varying size - origin or cause often unknown usually focal
30
splenic infarct?
acute and chronic, appear different grossly
31
acute splenic infarcts
- nodular "soft" enlargement - grossly: wedge-shaped, triangular hemorrhagic lesions (similar to kidneys) - often due to vasculitis and thrombosis
32
chronic splenic infarcts
gross appearance: wedge-shaped, pale grey/white, firm, often contracted due to fibrosis
33
what disease in swine causes acute splenic infarcts?
CLASSICAL SWINE FEVER vasculitis, thrombosis in spleen grossly: wedge-shaped or triangular hemorrhagic lesions
34
what disease in swine causes acute lymphoid necrosis and diffuse soft splenomegaly?
AFRICAN SWINE FEVER
35
what 2 diseases are we concerned about with pigs and their spleens?
CLASSICAL SWINE FEVER AFRICAN SWINE FEVER
36
how does african swine fever appear?
acute lymphoid necrosis: diffuse soft splenomegaly
37
T/F: african swine fever and classical swine fever are indistinguishable
true degeneration fo vascular endothelium and fibrin arterial changes are identical between the 2
38
what are 2 differentials for a soft splenic mass?
hemangiosarcoma hematoma
39
Signalment: 11-year-old MC Golden Retriever  History: Collapsed suddenly when jumping out of the car  Physical exam: Diffuse pallor, hemoabdomen w/ splenic mass  Leading differential?
hemangiosarcoma
40
hemangiosarcoma
- Malignant neoplasm of endothelial cells, forming chaotic blood vessels - Common primary tumor of the spleen (especially in dogs) and right auricle of the heart - metastasis often in lungs, liver, omentum, kidney, brain. anywhere with blood supply. mets often present at time of diagnosis
41
gross appearance of hemangiosarcoma
single or multifocal to coalescing dark red-purple masses which are variably bloody/cavitated to solidly cellular on cut section
42
what dog breeds are commonly affected by hemangiosarcomas?
 Golden Retrievers  German Shepherds  Portuguese water dogs
42
causes of nodular soft enlargement of spleen
 Hematomas  Acute splenic infarcts  Example: Classical Swine Fever (CSF)  Neoplasia  Example: Hemangiosarcoma
43
what are causes of diffuse, firm, meaty, solid splenomegaly?
- diffuse granulomatous disease - neoplasms - storage disease or amyloidosis
44
how does histoplasmosis affect the spleen?
- pale/tan from macrophages scattered in red pulp - macrophages contain multiple intracytoplasmic round yeasts firm, diffuse enlargement of the spleen
45
neoplasms of the spleen causing diffuse firm enlargement
round cell tumors: lymphoma, leukemia, visceral mast cell tumor, histiocytic sarcoma ***all of these neoplasms can produce nodular lesions instead of or along with a diffusely enlarged spleen***
46
T/F: neoplasms of the spleen can cause both nodular lesions and a diffuse enlargement
true
47
how can storage diseases occur with the spleen?
accumulation of amyloid in the spleen may occur with primary (AL) or secondary (AA) amyloidosis RARELY causes diffuse splenomegaly enlarged, pale, tan, firm, waxy
48
pale, tan and *waxy* are buzzwords for what condition?
AMYLOID
49
what are causes of nodular, firm, meaty, and solid splenomegaly?
- lymphoid and complex nodular hyperplasia - primary or metastatic neoplasia - granulomas or abscesses - extramedullary hematopoiesis
50
Signalment: 10-year-old FS Bernese Mountain Dog  Progressive history of lethargy, inappetence, weight loss, pale mucous membranes  Bloodwork: anemia, thrombocytopenia, Coombs test negative  Abdominal ultrasound: multifocal solid nodules scattered throughout the spleen  Leading differential?
Malignant neoplasm of monocytic/histiocytic origin (dendritic cells and macrophages)  Can arise within many tissues including the spleen, lung, liver, skin, articular surface of joints, and bone marrow HISTIOCYTIC SARCOMA! anemia is key
51
histiocytic sarcoma
malignant neoplasm of monocytic/histiocytic origin - hemophagocytic subtype "eats" RBCs, common primary tumor of the spleen or bone marrow gross appearance: single or multifocal - bernese mountain dogs, flat coated retrievers, goldens
52
how can histiocytic sarcoma present in the spleen?
NODULAR "firm" enlargement of the spleen ** can cause DIFFUSE firm enlargement of the spleen as well
53
neoplasia of the spleen
Primary Neoplasms  Derived from any “normal” elements of the red and white pulp, including stromal/supporting elements  Ex: Lymphoma (multiple subtypes), histiocytic sarcoma, splenic stromal sarcomas, solid hemangiosarcomas, myelolipomas, etc.  Metastatic Neoplasms  Sarcomas, carcinomas, malignant round cell tumors  Gross appearance largely depends on tumor type/cell of origin
54
what bacteria can cause splenic abscesses?
Pyogenic bacteria such as Streptococcus spp., Rhodococcus equi, Trueperella pyogenes, and Corynebacterium pseudotuberculosis
55
granulomas in the spleen
 Similar to list of “diffuse” granulomatous disease  Ex: tularemia, mycobacteria
56
what is nodular extramedullary hematopoiesis?
proliferation of hematopoietic precursor cells benign lesions seen in spleen
57
what findings on the spleen are common in older dogs?
siderotic plaques may be sequelae to previous hemorrhages from trauma to the spleen: usually combo fo RBC breakdown products, mineral, and fibrous connective tissue encrustations on the splenic capsule
58
accessory spleens?
Either from splenic rupture (A) or normal “extra” spleen (B, arrow)

BOD 3 Exam 1 (6 decks)

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