Spleen and Thymus Pathology Flashcards
What are 2 congenital splenic anomalies?
Congenital absence - rare
Accessory spleens - common
What is a worrisome complication of splenic insufficiency? Why?
Sepsis from encapsulated bacteria due to the loss of filtering and antibody production.
What symptoms may be noticed with splenomegaly?
LUQ mass effect leading to gastric/abdominal involvement.
Anemia, leukopenia or thrombocytopenia
Splenic rupture is common in which entities?
Mono
Malaria
Typhoid fever
Lymphoid neoplasms
What is hypersplenism?
When does it most commonly arise?
Is there a correlation between size of the spleen and severity of cytopenia?
A condition where the spleen becomes increasingly active and tends to remove circulating cells/cell products.
It is often in the setting of splenomegaly and commonly secondary to portal HTN and hematological disorders.
No, there is no correlation.
What is the cause of non-specific acute splenitis?
What happens to the spleen grossly and morphologically?
Secondary, non-specific reaction to any blood-borne infection.
Mild splenomegaly that is soft and fluctuant.
There is acute congestion of red pulp with infiltrates of neutrophils, plasma cells and +/- eosinophils.
What are 3 causes of congestive splenomegaly?
- Systemic, central or venous congestion.
- cardiac decompensation. - Cirrhosis of the liver (most common etiology).
- Obstruction of the extrahepatic portal or splenic veins.
- portal thrombosis, compression, etc. leading to mild-moderate enlargement. May have a sudden onset.
What is Budd-Chiari syndrome?
Occlusion of the hepatic v. It presents with abdominal pain, ascites and hepatomegaly. There is also a risk of splenomegaly. Mortality is high if not treated.
What morphological changes occur with congestive splenomegaly?
The spleen becomes more fibrous and cellular (often with hypersplenism) along with mineral/pigment deposition.
What causes a splenic infarct?
What is the downstream effect?
Occlusion of splenic aa. (cardiac emboli, sickle cell disease).
It can lead to decreased splenic function leading to an increased risk for infection.
What type of neoplasia occurs in the spleen?
It usually arises from secondary involvement in the setting of lymphoid or myeloid neoplasms.
DLBCL typically shows masses in the spleen.
What is the consequence of a splenic rupture?
What symptoms are seen?
It is a life-threatening cause of hemoperitoneum and hemorrhagic shock.
LUQ pain, left should pain (Kehr sign), signs of peritonitis and hemodynamic instability.
What does the thymus arise from?
Medulla is from the 3rd pharyngeal pouch (endoderm); cortex is from the pharyngeal cleft (ectoderm).
What causes the thymus to involute?
Age is the main reason, but it can involute with stress and HIV infection.
What is the size of a thymic cyst?
What is it made of?
Usually < 4 cm. They are uncommon and often found incidentally.
Stratified squamous to columnar epithelium surrounding serous or mucinous contents.
