Spleen and Thymus, Putthoff Flashcards
functions of the spleen
phagocytosis
Ab production
Hematopoiesis
Sequestration of formed blood elements
What are splenectomy patients prone to
infections from S pneumonia, N meninginitis, H influenza
Where in spleen do you find Ab secreting plasma cells
red pulp
What infections can cause splenomegaly
mononucleosis
what type of congestive disorders can cause splenomegaly
cirrhosis, R HF, portal thrombosis
how does increased Portal v Pressure lead to splenomegaly
increased deposition of collagen from increased pressure leads to dilation and slowing of blood so more is in spleen and mroe is destoryed
what are causes of portal thrombosis
intrahepatic obstructive diseases or carcinomas of the stomach or pancreas
what are Sx of splenomegaly
LUQ pressure abdominal discomfort thrombocytopenia anemia leukopenia
What lymphohematogenous disorders are assoc with splenomegaly
non-hodgkin lymphoma and lymphocytic leukemia
myeloproliferative disorders
what immune inflammatory proccesses are assoc with splenomegaly
SLE and RA
What is nons[ecific acute splenitis
secondary to any blood borne infections
mild splenomegaly
soft and fluctuant
acute congestion red pulp
what are the infiltrates composed of in nonspecific acute splenitis
neutrophils, plasma cells and maybe eos
Why do the spleens commonly infarct
lacks collarteral blood supply
usually emboli from endocarditis or damage from sickle cell
What do splenic infarcts look like
bland pale, wedge shaped and subcapsular
Describe neoplasms of the spleen
primary are extremely rare- hemangiomas and lymphangiomas
secondary are assoc with myeloproliferative syndromes or myeloid neoplasms (DLBCL common)
What are the congenital problems with spleens
absent- rare assoc with situs inversus
hypoplasia- common
accessory- common
what is important to check before providing Tx splenectomy
look for accessory spleen
what can cause rupture of spleen
trauma
mono, malaria, typhoid fever, lymphoid neoplasm
are chronic spleens with splenomegaly at increased risk of rupturing
no decreased because of all the fibrotic proccesses
Describe size of thymus over time
gets bigger than in adulthood shrinks to basicall just fatty fibrotic tissue
what can make thymus involute earlier on
severe illness or HIV
What cells are found in thymus
epithelial cells
immature T lymphocytes
macrophages, dendritic cells, B lymphocytes, neutrophils, eos, myoid cells
what are thymic epithelial cells in the medulla like
densely packed, spindle shaped called hassel corpuscles
keratinized cores
what marker stains the medullary epithelial cells in thymus
HLA-DR+
