Spleen Flashcards
What are 4 functions of the spleen that impact disease states?
Phagocytosis of blood cells
Antibody production
Hematopoietis with chronic or severe anemia
When splenomegaly occurs, sequesters blood cells and causes Penia.
What is the main concern/complication because of splenic insufficiency or not having a spleen?
Vulnerable to encapsulated pathogens like strep pneumonia and h influenza leading to sepsis. Spleen cant filter antigens, phagocytosis, or make antibody against these guys.
2 clinical symptoms because of a large spleen?
Dragging sensation in LUQ
Stomach/abdominal discomfort after eating
What is the syndrome associated with spleen enlargement, how do we characterize it and what is the cause?
Hypersplenism syndrome
Thrombocytopenia, leukopenia, and anemia
Caused by sequestering the products and eating them up by macros
Hypersplenism is most common secondary to what?
Portal HTN and hematological disorders
What is the cause of non specific acute splenitis and how do we characterize it?
Any blood borne infection
Mild splenomegaly with acute congestion of red pulp
What are the 2 main infiltrates with non specific acute splenitis and what other infiltrate can be present?
Neutrophils and plasma cells
Eosinophils
3 main types of congestive splenomegaly?
Central/systemic venous congestion
Cirrhosis
Obstruction of extrahepatic portal vein or splenic vein
What is going on with central/systemic venous congestion and how big is the splenomegaly?
Right heart sided failure
Moderate enlargement, no bigger than 500 g
What is going on with cirrhosis of the liver and how big is the splenomegaly?
Alcohol or schisto cirrhosis is the most common cause of significant splenomegaly.
Two ways we can get obstruction of portal and splenic vein?
Spontaneous thrombosis in portal vein
Invading pancreatic and gastric tumors
What is the morph sign of early chronic congestion and then a sign of long standing congestion?
Red pulp congestion
More fibrous and cellular
Why are splenic infarcts common? Where do the thrombi most commonly come from? Also, what are 4 settings where we can get an infarction more easily? What is the concern with an infarction?
Lack collateral flow, like kidney and brain.
Heart
Sickle cell, IE, splenomegaly, and myeloproliferative diseases
Spleen insufficiency, so encapsulated pathogens causing sepsis
What two tumors are most common in the spleen and give a specific example?
If primary occur, what are the tumors and what are the two most common?
Myeloid and lymphoid neoplasms that are secondary. DLBCL.
Benign, lymphangioma and hemangioma.
Is splenic aplasia or hypoplasia more common?
What do we need to consider about accessory spleens?
Hypoplasia.
If you are taking a spleen out for ITP or hereditary spherocytosis then you need to make sure they don’t have an extra spleen.
