Spleen - Part 1

Question 1

Hamartoma

Answer 1

A rare benign neoplasm composed of lymphoid tissue

Question 2

What is hamartoma also known as?

Answer 2

Splenoma

Question 3

Leukocytosis

Answer 3

WBC count above 20,000 mm3

Question 4

Leukopenia

Answer 4

WBC count below 4000 mm3

Question 5

What are the functions of the spleen? (4)

Answer 5

1. Removes foreign material from the blood
2. Initiates an immune reaction, resulting in production of antibodies and
   lymphocytes
3. Major destruction site of old RBCs
   - RBCs are removed and Hb is recycled
4. Reservoir for blood

Question 6

Where does the splenic artery arise from?

Answer 6

The celiac axis

Question 7

What does the splenic vein join with to form the main portal vein?

Answer 7

SMV

Question 8

In cases of portal hypertension, where can the splenic vein shunt blood into?

Answer 8

The left renal vein

Question 9

Is the spleen an intra or retroperitoneal organ ?

Answer 9

Intraperitoneal

Question 10

Where is the spleen located compared to the diaphragm, left kidney, stomach and the pancreas?

Answer 10

1. Diaphragm = inferior
2. Left kidney = anterior
3. Stomach = posterior and lateral
4. Lateral

Question 11

Accessory spleen

Answer 11

Improper splenic fusion

Question 12

What is a clinical finding for an accessory spleen?

Answer 12

Asymptomatic

Question 13

What is the US appearance for an accessory spleen? (4)

Answer 13

1. Homogeneous mass typically located medial to the splenic hilum
2. Echogenicity similar to spleen
3. Round or oval in shape
4. Variable size

Question 14

What are 3 differential diagnosis for an accessory spleen?

Answer 14

1. Lymphadenopathy
2. Pancreatic mass
3. Adrenal mass

Question 15

Aplasia

Answer 15

Failure of the spleen to develop

Question 16

What is a clinical finding for aplasia?

Answer 16

Asymptomatic

Question 17

What is the US appearance for aplasia?

Answer 17

Absence of the spleen

Question 18

What are 2 differential diagnosis for aplasia?

Answer 18

1. Splenectomy

2. Wandering spleen

Question 19

Polysplenia

Answer 19

Multiple small spleens

Question 20

What are the clinical findings for polysplenia? (2)

Answer 20

1. Asymptomatic

2. Varies with associated congenital anomalies

Question 21

What is the US appearance for polysplenia? (3)

Answer 21

1. Multiple small spleens
2. Located along the greater curvature of the stomach
3. Associated with gastrointestinal, cardiovascular, and biliary anomalies

Question 22

What are 2 differential diagnosis for polysplenia?

Answer 22

1. Lymphadenopathy

2. Retroperitoneal masses

Question 23

Wandering spleen

Answer 23

Improper fusion of the dorsal mesentery with the posterior peritoneum

Question 24

What is a clinical finding for a wandering spleen?

Answer 24

Asymptomatic

Question 25

What is the US appearance for a wandering spleen?

Answer 25

Abnormal location of the spleen

Question 26

What are 2 differential diagnosis for a wandering spleen?

Answer 26

1. Asplenia | 2. Splenic rupture

Question 27

What is the normal US appearance of the spleen? (2)

Answer 27

1. Moderately echogenic homogeneous parenchyma | 2. Isoechoic to slightly hypo echoic compared to the normal liver parenchyma

Question 28

What are the measurements for the spleen? (L, W, H)

Answer 28

``` Length = 10-12cm Width = 7cm Thickness = 3-4cm ```

Question 29

What are the causes of splenomegaly? (10)

Answer 29

1. Congestive heart failure 2. Cirrhosis 3. Portal hypertension 4. Portal vein thrombosis 5. Infection 6. Diabetes mellitus 7. Hypertension 8. Hepatitis 9. Trauma 10. Hemolytic anemia

Question 30

What are the clinical findings for splenomegaly? (5)

Answer 30

1. Asymptomatic 2. Dyspepsia - hard to digest 3. Fatigue 4. Abdominal pain 5. Palpable LUQ mass

Question 31

What is the US appearance for splenomegaly? (5)

Answer 31

1. Enlargement of the spleen 2. Length exceeding 13cm 3. Hypo echoic parenchyma 4. Evaluate liver for pathology 5. Evaluate abdominal cavity for ascites

Question 32

What are 2 differential diagnosis for splenomegaly?

Answer 32

1. Technical error | 2. Splenic rupture