Splenic Pathology

Question 1

what is splenomegaly?

Answer 1

enlargement of the spleen, where it is usually measuring greater than 13cm in length

Question 2

what are the clinical signs of splenomegaly?

Answer 2

• LUQ pain
• feeling of fullness
• palpable enlargement of spleen

Question 3

what is venous congestion of the spleen?

Answer 3

can be acute or chronic, but it is where the vascular supply for the spleen is congested.

Question 4

what are storage diseases that affect the spleen?

Answer 4

amyloidosis
Gaucher’s disease
Niemann-Pick disease

Question 5

what is amyloidosis?

Answer 5

a condition in which an abnormal protein (amyloid) builds up in tissues and organs. Most commonly in the spleen

Question 6

what is Gaucher’s disease?

Answer 6

a hereditary disease in which the storage and metabolism of lipids is abnormal.

Question 7

what is Niemann-Pick disease?

Answer 7

Lipid storage disorder. Rapidly-progressing fatal disease that primarily affects female infants.

Question 8

what is sickle cell anemia?

Answer 8

a form of anemia in the RBCs where they are crescent-shaped and fragile

Question 9

what are the clinical signs of sickle cell anemia?

Answer 9

episodes of pain, anemia, fatigue, delayed growth, etc.

Question 10

what is the sonographic appearance of sickle cell anemia?

Answer 10

Hypoechoic lesions are also called infarcts in patients with sickle cell anemia.

Question 11

what is congenital spherocytosis?

Answer 11

RBCs are small and spheroid
sonographically, the spleen will appear enlarged

Question 12

hemolytic anemia

Answer 12

anemia linked to decreased life of RBCs. can occur as a primary disease, or be secondary to another disorder such as lymphoma, leukemia, or infection mononucleosis. spleen appears enlarged

Question 13

polycythemia vera

Answer 13

an excess of RBCs and hemoglobin concentration. causes an enlarged spleen, infarcts, and thromboses.

Question 14

what are the clinical signs for polycythemia vera?

Answer 14

weakness, fatigue, vertigo, tinnitus, irritability, splenomegaly, flushing of the face, redness and pain in the extremities, and blue/black spots

Question 15

Thalassemia

Answer 15

a hemoglobinpathy that results in RBCs deficient in hemoglobin and abnormal in shape; therefore destroyed by the spleen

• spleen is grossly enlarged and takes up entire abdominal cavity

Question 16

lymphopoietic Abnormalities

Answer 16

includes leukemia, lymphoma, and hodgkins disease

• diffusely hypoechoic spleen with focal lesions, some types of leukemia have more extreme splenomegaly than any other disease

Question 17

splenic abscess

Answer 17

an uncommon focal disease most likely caused by infections in adjacent organs

Question 18

what are the clinical signs of a splenic abscess?

Answer 18

fever, LUQ tenderness, abdominal pain, left shoulder and flank pain, splenomegaly

Question 19

what is the sonographic appearance of a splenic abscess?

Answer 19

difficult to differentiate from an infarction, so clinical correlation is necessary. lesions can appear simple or mixed, well-defined or poorly-defined, and it can include gas or debris