spleen powerpoint

Question 1

2 main functions of spleen

Answer 1

• Defense against disease
  * Produces lymphocytes and plasma cells
  * prevents infection (especially in children)
• Erythropoiesis
  * In fetal period, responsible for producing
  erythrocytes (RBC)
  * although bone marrow assumes the function after
  birth, spleen retains capacity to produce red blood
  cells throughout life
• Destruction and removal of defective red blood cells
• Acts as storage depot

Question 2

how does the spleen defend against disease?

Answer 2

• Produces lymphocytes and plasma cells
• prevents infection (especially in children)

Question 3

where does the Destruction and removal of defective red blood cells occur

Answer 3

mainly in the cord of Billroth

• Destroys aged RBCs and metabolizes their iron for
  reuse in hemoglobin
• Removes defective cells (i.e. spherocytes, sickle cells,
  and thalassemic cells); called culling
• Cells with a granular inclusion or parasites are not
  culled, only the extraneous material is removed and
  RBC returned to circulation; called pitting

Question 4

what is culling

Answer 4

removal of defective cells

Question 5

what is pitting

Answer 5

removal of the extraneous material and rbc returned to circulation

Question 6

how does the spleen act as storage depot

Answer 6

• Stores iron and other metabolites
• Pooles platelets in large numbers

Question 7

spleen Echogenicity is comparable to the ________

Answer 7

liver

Question 8

spleen pathology

Answer 8

Changes in size Trauma
* Splenomegaly - Hematoma
* Atrophy - Splenic rupture
Focal lesions Diffuse Diseases
* Abscesses - Sickle cell anemia
* Infarcts - Hemolytic anemia
* Cysts - Polycythemia vera
* Tumors - Thalassemia
- Leukemia

Question 9

name pathology

Clinical symptoms include LUQ fullness or pain, jaundice,
lymphadenopathy, fever, or hemorrhage
>13cm

Answer 9

spleenomegaly

Question 10

name pathology

• Occurs in “wasting” diseases (chronic hemolytic
  anemias)
• Characterized by an excessive loss of pulp, increasing
  fibrosis, scarring, and incrustation with iron and
  calcium deposits
• Spleen may get very small

Answer 10

atrophy

Question 11

• Calcifications
• Sickle-Cell anemia
• Polycythemia vera
• Thalassemia
• Leukemia
• Aids

Answer 11

diffuse diseases

Question 12

• Appear echogenic
• Demonstrate varying degrees of shadowing
• Can be caused by granulomatous disease -
  histoplasmosis, or TB
• Can result from previous infarction or hematoma

Answer 12

SPLENIC CALCIFICATIONS

Question 13

• Early stages, spleen is enlarged
• Later, spleen undergoes progressive infarction and
  fibrosis

Answer 13

SICKLE-CELL ANEMIA

Question 14

• An abnormal proliferation in bone marrow elements,
  red cell mass, and total blood volume
• Spleen is variably enlarged
• Infarcts and thrombosis are common

Answer 14

POLYCYTHEMIA VERA

Question 15

• Synthesis of normal hemoglobin is suppressed
• Spleen is VERY large

Answer 15

THALASSEMIA

Question 16

2 types of leukemia

both produce inhomogeneous spleen

Answer 16

Chronic myelogenous leukemia
Chronic lymphocytic leukemia

Question 17

which form of leukemia forms the largest spleenomegaly

Answer 17

chronic myelogenous leukemia

Question 18

A progressive, malignant
disease of the blood-
forming organs,
characterized by distorted
proliferation and
development of leukocytes

Answer 18

leukemia

Question 19

• Frequently accompanied by infections and lymphoma
• Splenomegaly is common
• May appear as hypodense nodular implants within
  splenic parenchyma

Answer 19

AIDS

Question 20

4 focal lesions of spleen

Answer 20

• Abscess
• Infarcts
• Cysts
• Neoplasms

Question 21

abscess description

Answer 21

Single, focal abscesses within spleen are uncommon
* More often multiple
* Result from infection
* Complex in appearance; mixed echogenic properties
* Similar appearance to metastatic lesions and hematomas
* Pt presents with classic signs of infection (fever,
tenderness, WBC elevated)

Question 22

INFARCTION ultrasound description and why it happens

Answer 22

Disruption of the blood flow to the organ. Sonographically
appears as a well-demarcated, hypoechoic wedge-shaped or
round area located at the periphery of the organ, ranging
from 1-2 cm (becomes increasingly echogenic with time)

Question 23

can spleen cyst be congenital

Answer 23

yes and can also be acquired

Question 24

ACQUIRED SPLEEN CYST ARE EITHER _________
OR _________

Answer 24

PARASITIC
NON-PARASITIC

Question 25

Cystic disease of the spleen is an (common/uncommon) condition and the majority of cases are due to parasitic infection with Echinococcus granulosus resulting in hydatid disease

Answer 25

uncommon

Question 26

* Epidermoid cysts - congenital * Usually solitary and unilocular * Rarely contain calcification * More common in females * Should demonstrate characteristics of cyst

Answer 26

spleen primary cyst

Question 27

Spleen is most frequently damaged organ in blunt abdominal trauma: * Fracture of capsule * Parenchymal lacerations * Focal parenchymal or subcapular hematoma

Question 28

tumors- spleen * Rare * Benign or malignant * Benign tumors are generally isoechoic and will demonstrate splenomegaly

Answer 28

BENIGN Hamartoma Hemangioma Cystic lymphangioma MALIGNANT Lymphoma Hodgkin's tumor Hemangiosarcoma

Question 29

* Composed of lymphoid tissue and normal splenic tissue (an overgrowth of mature cells & tissues that normally occur in the spleen) * Has both solid and cystic components * Generally hyperechoic * May be solitary or multiple * Well defined-not encapsulated

Answer 29

HAMARTOMA

Question 30

* Most common benign neoplasm of the spleen * 1:600 at autopsy * Either capillary or cavernous types * Sonographic appearance is variable * May be complicated by rupture * May be isoechoic or complex making it difficult to sonographically differentiate from other splenic processes

Answer 30

HEMANGIOMA

Question 31

* A malformation of lymphatics * Appears as mass with extensive cystic spaces * Usually involves multiple organs * Rarely involves spleen

Answer 31

CYSTIC LYMPHANGIOMA

Question 32

* Usually begins in lymph nodes, the most common site of extranodal involvement is spleen, but primary disease in spleen is rare * Irregular tumor-like nodules will appear in the spleen * Sonographically may appear as focal hypoechoic or hyperechoic masses, diffuse splenomegaly, or normal splenic contour and size

Answer 32

HODGKIN'S TUMOR (malignant neoplasm)

Question 33

* Rare, but most common PRIMARY splenic malignancy * Arises from vascular endothelium of spleen * Usually has a mixed cystic ultrasound pattern—and/or may be hyperechoic * Grow rapidly and metastasize early * May rupture spontaneously due to fast growth

Answer 33

HEMANGIOSARCOMA(malignant neoplasm)

Question 34

* Metastasis is uncommon * ___________ is most frequent metastatic lesion within spleen (board question) * Also can spread from lung, breast, pancreas, and ovary—there is no way for us to know where it came from

Answer 34

Melanoma

Question 35

* _______________________- is a term that refers to a group of cancers of the lymphatic system (there are many types and sub-types of NHL) * These cancers can have different symptoms and signs, findings on a physical examination, and treatments. * May result in splenic enlargement

Answer 35

Non-Hodgkin lymphoma (NHL)