Spleen and Thymus, Putthoff Flashcards Preview

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Flashcards in Spleen and Thymus, Putthoff Deck (43):
1

functions of the spleen

phagocytosis
Ab production
Hematopoiesis
Sequestration of formed blood elements

2

What are splenectomy patients prone to

infections from S pneumonia, N meninginitis, H influenza

3

Where in spleen do you find Ab secreting plasma cells

red pulp

4

What infections can cause splenomegaly

mononucleosis

5

what type of congestive disorders can cause splenomegaly

cirrhosis, R HF, portal thrombosis

6

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

7

what are causes of portal thrombosis

intrahepatic obstructive diseases or carcinomas of the stomach or pancreas

8

what are Sx of splenomegaly

LUQ pressure
abdominal discomfort
thrombocytopenia
anemia
leukopenia

9

What lymphohematogenous disorders are assoc with splenomegaly

non-hodgkin lymphoma and lymphocytic leukemia
myeloproliferative disorders

10

what immune inflammatory proccesses are assoc with splenomegaly

SLE and RA

11

What is nons[ecific acute splenitis

secondary to any blood borne infections
mild splenomegaly
soft and fluctuant
acute congestion red pulp

12

what are the infiltrates composed of in nonspecific acute splenitis

neutrophils, plasma cells and maybe eos

13

Why do the spleens commonly infarct

lacks collarteral blood supply
usually emboli from endocarditis or damage from sickle cell

14

What do splenic infarcts look like

bland pale, wedge shaped and subcapsular

15

Describe neoplasms of the spleen

primary are extremely rare- hemangiomas and lymphangiomas
secondary are assoc with myeloproliferative syndromes or myeloid neoplasms (DLBCL common)

16

What are the congenital problems with spleens

absent- rare assoc with situs inversus
hypoplasia- common
accessory- common

17

what is important to check before providing Tx splenectomy

look for accessory spleen

18

what can cause rupture of spleen

trauma
mono, malaria, typhoid fever, lymphoid neoplasm

19

are chronic spleens with splenomegaly at increased risk of rupturing

no decreased because of all the fibrotic proccesses

20

Describe size of thymus over time

gets bigger than in adulthood shrinks to basicall just fatty fibrotic tissue

21

what can make thymus involute earlier on

severe illness or HIV

22

What cells are found in thymus

epithelial cells
immature T lymphocytes
macrophages, dendritic cells, B lymphocytes, neutrophils, eos, myoid cells

23

what are thymic epithelial cells in the medulla like

densely packed, spindle shaped called hassel corpuscles
keratinized cores

24

what marker stains the medullary epithelial cells in thymus

HLA-DR+

25

describe the cortical thymic epithelial cells

polygonal with lots of cytoplasm

26

what is role of immature T lymphocytes in thymus

go through Ag dep T cell maturation
- and + selection

27

What are the developmental disorders of thymus

Digeorge 22q11 which has severe defects in cell mediated immunity and assoc with hypothyroidism

28

What are thymic cysts

benign usually less than 4 cm and stratified squamous- columnar epithelium
fluid inside is serous or mucinous

29

If you found a cystic thymic mass what do you need to look for

neoplasm

30

What is thymic hyperplasia

thymic follicular hyperplasia of B lymphocytes

31

thymic hyperplasia is common in what other conditions

myasthenia gravis
graves, SLE, RA, scleroderma

32

What are thymomas

tumors of the thymic epithelial cells

33

what do the thymomas look like

lobulated gray-white masses often encapsulated

34

what are the types of thymomas

cytologically benign noninvasive
malignant I/cytologically benign and invasive
malignant II cytologically metastatic

35

where are thymomas usually found

anterosuperior mediastinum, neck, thyroid, pulmonary hilus, posterior mediastinum

36

dist thymomas

>40 M=F rarely in children

37

what is prognosis of type I bengin but invasive thymoma

minimal invasion with complete excision 5 yr survival >90%
extensive invasion 5 yr survival <50%

38

what are the subtypes of II malignant thymoma

squamous cell carcinoma
lymphoepithelioma

39

lymphoepithelioma thymomas are assoc with what commonly

EBV

40

what do metastatic thymomas look like

fleshy and obviously invasive

41

Sx of thymomas

impingement of mediastinal structures

42

What are thymomas assoc with

myasthenia gravis!
hypogammaglobulinemia, pure red cell aplasia, graves, pernicious anemia, dermatomyositis-polymyositis and cushings

43

which type thymomas are more common assoc with autoimmune

cortical thymomas