Chapter 11- Spleen

Question 1

What does the spleen produce during embryonic life?

Answer 1

Red and white blood cells.

Question 2

The spleen is part of what body systems?

Answer 2

Lymph and reticuloendothelial systems

Question 3

What are the normal measurements of a spleen

Answer 3

8-13 cm long, 7 cm wide, and 3 to 4 cm thick

Question 4

What is a wandering spleen and what causes it?

Answer 4

spleen that has migrated from its normal location in the left upper quadrant caused by improper fusion of the dorsal mesentery with the posterior peritoneum

Question 5

What are the most common causes of granulocytopoietic abnormalities?

Answer 5

Histoplasmosis and tuberculosis

Question 6

What is sarcoidosis?

Answer 6

an inflammatory disease that affects lungs and lymph nodes. It is a granulocytopoietic infection.

Question 7

What is a granuloma? How do they appear sonographically?

Answer 7

focal lesions resulting from previous infections. Hyperechoic foci throughout splenic parenchyma and possibly in the liver and lungs.

Question 8

What is Reticuloendotheliosis?

Answer 8

Includes diseases characterized by reticulo-endothelial hyperactivity
and varying degrees of lipid storage in phagocytes.

Question 9

What is Letterer-Siwe Disease?

Answer 9

Non-Lipid Reticuloendotheliosis Proliferation of reticuloendothelial cells throughout the body, particularly in bone marrow and spleen.

Question 10

Who does Letterer-Siwe Disease affect? Is it common? What are symptoms?

Answer 10

It is rare with poor prognosis. It affects children under 2. Hepatosplenomegaly, fever.

Question 11

What is Hand-Schuller-Christian Disease

Answer 11

Benign and chronic inflammatory disese that affects children older than 2 years. symptoms are diabetes and hepatosplenomegaly.

Question 12

Is splenic abscess common? Why?

Answer 12

Uncommon, because of the phagocytic activity of the spleen’s efficient reticuloendothelial system and leukocytes

Question 13

What are sonographic findings of Lymphopoietic abnormalities?

Answer 13

iso or hypoechoic splenic pattern with focal lesions

Question 14

How might a splenic abscess apper if it occurs?

Answer 14

pyogenic, atypically pyogenic with gas reverberations, microabscesses with a target appearance

Question 15

How might splenic infections appear?

Answer 15

splenomegaly. immunicomprimised patients have multiple nodules within the spleen

Question 16

What is splenic candidiasis

Answer 16

a fungal infection that appears target-like that is found in immunocomprimised patients.

Question 17

How do mycobacterial splenic infections appear?

Answer 17

tiny, diffuse echogenic foci throughout the spleen

Question 18

How does Acquired Immunodeficiency Syndrome (AIDS) appear?

Answer 18

Multiple organs are involved liver, kidney etc. Moderate splenomegaly, Focal splenic lesions displaying small round lesions that may be multiple, hypoechoic, and well-defined.

Question 19

What is the most common cause of a focal splenic lesion or infarction?

Answer 19

occlusion of the major splenic artery or any of its branches. This usually occurs as a result of emboli from the heart

Question 20

What are symptoms and the appearance of a splenic infarction?

Answer 20

LUQ pain or asymptomatic. Peripheral, wedge-shaped lesions on the edge of a spleen. hypo or hyperechoic depending on age of bleed.

Question 21

The spleen is most commonly injured as a result of …?

Answer 21

Blunt abdominal trauma

Question 22

If the patient has severe left upper quadrant pain secondary to
trauma, what pathology should we consider?

Answer 22

splenic or subcapsular hematoma

Question 23

What parts of the body is a Splenic Trauma FAST exam?

Answer 23

The RUQ, LUQ pericardial, and bladder regions will be examined for free fluid

Question 24

Where do splenic cysts come from?

Answer 24

They may be congenital, acquired from infection trauma or infarction, or associated with polycystic disease

Question 25

Where are small splenic cysts located? Where are large?

Answer 25

Small cysts are usually located within the parenchyma Large cysts can be exophytic?

Question 26

What is different about a posttraumatic or pseudocyst?

Answer 26

They no not have a cellular lining but walls might be calcified.

Question 27

What is Posttraumatic Splenosis

Answer 27

When a spleen is damaged, splenic cells can be released within the body and grow into additional spleens.

Question 28

What is a primary congenital cyst called? What differentiates it?

Answer 28

Also called epidermoid cysts, it is diferentiated by the presence of an epithelial lining.

Question 29

What splenic cyst comes from a parasite?

Answer 29

Echinococcal cysts

Question 30

What is the first indication of a splenic abnormality?

Answer 30

splenomegaly

Question 31

What are symptoms and sonographic appearance of Hamartoma?

Answer 31

Patient is asymptomatic. tumor might be solitary or multiple and well defined, hyperechoic and complex.

Question 32

What is the most common benign splenic neoplasm

Answer 32

cavernous hemangioma

Question 33

What is cavernous hemangioma and when would symptoms occur?

Answer 33

an isolated, echogenic mass with multiple small hypoechoic areas. the patient becomes symptomatic when the spleen swells and compresses organs or with rupture.

Question 34

What is a cystic lymphangioma? How does it appear?

Answer 34

A benign malformation of lymphatic vessels, consisting of endothelium- lined cystic spaces. Appears polycystic

Question 35

What is hemangiosarcoma?

Answer 35

a rare, malignant neoplasm from the blood vessel's epithelial cells of the spleen

Question 36

What are symptoms and the appearance of hemangiosarcoma?

Answer 36

Anemia, LUQ pain, Leukocytosis. Complex or hyperechoic

Question 37

What are the two types of Lymphoma? What differentiates them?

Answer 37

Hodgkin's (with the presence of Reed-Sternberg cells) and Non-Hodgkin's

Question 37

What is lymphoma

Answer 37

Malignant disorder involving the lymph system

Question 38

What is leukemia and how does it appear sonographically?

Answer 38

Destruction of white blood cells. splenomegaly, echogenic areas, nodules

Question 39

How common is metastasis in the spleen? What is the most common primary site of metastasis to the spleen.

Answer 39

The spleen is the tenth most common site of metastases. Melanoma is the most common rimary site.

Question 40

How are splenic artery aneurysms most commonly identified?

Answer 40

They appear as a calcified circle on X ray.

Question 41

What are risk factors of a splenic artery aneurysm? What demographic is most prevalent?

Answer 41

Atherosclerosis, portal hypertension. infection, trauma. Female prevalence.

Question 42

What is Hereditary spherocytosis? What is the main symptom?

Answer 42

RBCs are shaped like spheres and are destoryed prematurely leading to anemia.

Question 43

what is the most common congenital anomaly of the spleen? Where are they most commonly found?

Answer 43

splenunculus or accessory spleens (up to 30 percent of patients.) Most commonly found in the hilum.

Question 44

Portal hypertension, congestion, neoplasm, storage disease, infection, anemia, and trauma are all causes of what disease?,

Answer 44

splenomegaly

Question 45

What is splenic congestion and what is it caused by?

Answer 45

blood flow out of the spleen is blocked. Caused by Portal HTN, thrombosis, heart failure, cystic fibrosis

Question 46

What is Amyloid?

Answer 46

an abnormal protein usually produced by cells in the bone marrow that can be deposited in any tissue or organ

Question 47

What is Amyloidosis? How might it appear sonographically?

Answer 47

Buildup of amyloid proteins in an organ. The spleen may be normal or enlarged depending on the amount of amyloid

Question 48

What is the difference between nodular and diffuse Amyloidosis?

Answer 48

Nodular: Amyloid is found in walls of arteries and follicles. Diffuse: Amyloid is found in Red pulp and spleen is large and firm.

Question 49

What is Gaucher disease? What are symptoms?

Answer 49

Gaucher disease is an abnormal storage of proteins and fat. Symptoms include bone pain and skin pigmentation changes.

Question 50

Who is affected by Gaucher disease?

Answer 50

50% of patients are under 8 and 17% are under 1 year.

Question 51

How does Gaucher disease appear sonographically?

Answer 51

splenomegaly, splenic nodules, complex

Question 52

What is Niemann-Pick disease and who does it most commonly affect?

Answer 52

It is a rapidly fatal disease that causes the abnormal storage of fat. It typically affects female infants.

Question 53

What symptoms is Niemann-Pick associated with?

Answer 53

digestive issues, hepatomegaly, and lymphadenopathy

Question 54

What is sickle cell anemia? What demographic is most common

Answer 54

Sickle shaped RBCs get stuck in blood vessels which slows or blocks blood travel and oxygen. It more commonly affects black populations

Question 55

How does sickle cell anemia appear sonographically?

Answer 55

Acute SCA appears In children as splenomegaly and a decreased hematocrit. It may develop hemorrhage in the periphery.

Question 56

What are the results of congenital spherocytosis?

Answer 56

Production of spherocytic erythrocytes by the bone marrow or increased destruction of these cells in the spleen.

Question 57

What is hemolytic anemia?

Answer 57

Premature destruction of red blood cells. It can occur without other disease or secondary to other reticuloendothelial diseases.

Question 58

What is polycythemia vera?

Answer 58

A chronic disease with unknown cause involving bone marrow elements. An increase in red blood cell and hemoglobin concentration.

Question 59

How might polycythemia vera appear sonographically?

Answer 59

Enlarged, firm, and with thrombosis or infarctions.

Question 60

What is thalassemia?

Answer 60

Short-lived RBCs because the spleen destroys them in large numbers. It appears as a massive spleen.

Question 62

What is the spleen likely to look like in adults with advanced sickle cells anemia?

Answer 62

It will likely atrophy

Question 63

Does hamartoma have a capsule?

Answer 63

No

Question 64

Lymph nodes emerge from the splenic hilum and course along which vessel?

Answer 64

The splenic artery

Question 65

Massive splenomegaly is most often a result of?

Answer 65

Myelofibrosis

Question 66

Is the spleen retroperitoneal?

Answer 66

No it is intraperitoneal

Question 67

What is another name for Letterer Siwe disease?

Answer 67

Non-Lipid Reticuloendotheliosis

Question 68

What are the two main ligaments of the spleen?

Answer 68

Splenorenal and Gastrosplenic

Question 69

What condition is associated with polysplenia?

Answer 69

Bilateral Left-Sidedness

Question 70

What condition is associated with asplenia?

Answer 70

Bilateral right-sidedness

Question 71

What are functions of the spleen

Answer 71

Blood reservoir, destruction of blood cells, immunity, production of lymphocytes