Lesson 5A (Part 3)

Question 1

What is observed in the spleen in patients with portal hypertension?

Answer 1

Linear reflective channels

Question 2

What is the splenic interface sign

Answer 2

Dilatation of intrasplenic
venous sinuses with increased collagen in the walls and periarterial fibrosis
- back up of flow

Question 3

Hypersplenism

Answer 3

Over active spleen

- removes blood cells too early/quickly

Question 4

What can happen with hypersplenism?

Answer 4

Spontaneous splenic rupture may occur in a patient if an enlarged spleen has minimal trauma or coughing fit

Question 5

What are indications of a spleen exam? (3)

Answer 5

1. Mononucleosis
2. Congestion
3. Inflammatory
   - rheumatologic
4. Neoplasia
5. Infiltrative
6. Hematologic

Question 6

What is the the most common “infectious” reason for ordering an ultrasound?

Answer 6

Mononucleosis

Question 7

Sarcoidosis

Answer 7

Is a multisystem granulomatous disease that is associated with splenomegaly

Question 8

Mononucleosis

Answer 8

Is an infectious disease where patients feel tired and weak for months because it affects the immune system and causes splenomegaly

Question 9

What are 2 complications of mononucleosis?

Answer 9

1. Splenic infarct

2. Rupture

Question 10

Non-Hodgkins/Hodgkins Lymphoma

Answer 10

Cancer of the lymphatic system

Question 11

What kind of nodules do patients with Non-Hodgkins/Hodgkins Lymphoma have? (3)

Answer 11

1. Lymphoma
2. Sarcoidosis
3. TB

Question 12

How does Non-Hodgkins/Hodgkins Lymphoma appear? (3)

Answer 12

1. Focal lesions
2. Hypoechoic
3. Hypovascular

Question 13

Is Non-Hodgkins/Hodgkins Lymphoma benign or maligant?

Answer 13

Malignant

Question 14

Hodgkins Disease

Answer 14

Abnormal cells

• Reed sternberg cell
• must be examined under a microscope

Question 15

What are symptoms of Non Hodgkins Disease? (4)

Answer 15

1. Painless swelling of lymph nodes
2. Fever
3. Weight loss
4. Night sweats

Question 16

What is more common Non Hodgkins Disease or Hodgkins Disease?

Answer 16

Non Hodgkins Disease

Question 17

Hemangiosarcoma

Answer 17

Most common malignant, primary, nonlymphoid tumour of the spleen
- but is rare

Question 18

What is the prognosis for hemangiosarcoma?

Answer 18

Poor

- usually related to splenic rupture

Question 19

What are clinical symptoms of hemangiosarcoma? (5)

Answer 19

1. Abdominal pain
2. Left upper quadrant mass
3. Anemia
4. Thrombocytopenia
5. Coagulopathy

Question 20

How can hemangiosarcoma present?

Answer 20

As a well-defined hemorrhagic nodule

Question 21

What is seen in malignant melanoma?

Answer 21

Metastases to the spleen

- although rare

Question 22

What is the most common primary benign neoplasm?

Answer 22

Hemangioma

Question 23

How does hemangioma appear? (2)

Answer 23

1. Well defined

2. Echogenic

Question 24

What are considered not true cysts? (3)

Answer 24

1. Metastases
2. Abscess
3. Hematoma

Question 25

What are examples of splenic cysts? (6)

Answer 25

1. Congenital 2. Pseudocysts - no endothelium 3. Hydatid 4. Pancreatic pseudocysts - pancreatitis 5. Endothelial-lined cysts > lymphangiomas and cystic hemangiomas 6. Peliosis - extremely rare

Question 26

What are congenital cysts considered? (2)

Answer 26

1. Epidermoid | 2. True cysts

Question 27

How do congenital cysts appear? (4)

Answer 27

1. Well defined 2. Thin walled 3. Anechoic lesions 4. Do not change over time

Question 28

Are congenital cysts benign or malignant?

Answer 28

Benign

Question 29

What is a splenic pseudocyst known as?

Answer 29

Fasle cyst | - no cellular lining

Question 30

What causes splenic pseudocyst? (3)

Answer 30

1. Trauma 2. Infarction 3. Infection

Question 31

How does splenic pseudocyst appear? (5)

Answer 31

1. Complex 2. Wall calcifications 3. Internal echoes 4. Debris 5. Hemorrhage