ch 15 the spleen (pathology)

In the _________, the follicles are not involved, the red pulp is prominently involved, and the spleen is usually greatly enlarged and firm.

diffuse type

splenomegaly

enlargement of the spleen Long axis ≥13 cm

Niemann-Pick Disease Clinical features consist of

hepatomegaly, digestive disturbances, and lymphadenopathy.

The spleen may grow to enormous size with extension into the ________.

iliac fossa

Erythropoietic abnormalities On ultrasound, they tend to produce an _______ pattern.

isoechoic

Enlargement of the spleen may encroach upon surrounding organs, such as the ___________.

left kidney, pancreas, stomach, and intestines.

Clinical signs of splenomegaly may include_____________.

left upper quadrant pain (secondary to stretching of the splenic capsule or ligaments) or fullness.

the speen is Rarely the _______ of disease

primary site

Erythropoietic abnormalities include the following:

sickle cell, hereditary spherocytosis, hemolytic anemia, chronic anemia, polycythemia vera, thalassemia, and myeloproliferative disorders.

When the spleen is involved in systemic disease, splenic enlargement; ________ usually develops.

splenomegaly

_________ is the most common disease process encountered by the sonographer when evaluating this organ, careful evaluation of splenic contour and homogeneity should be undertaken to determine whether a disease process involves the spleen.

splenomegaly

Gaucher's Disease On ultrasound examination,

-splenomegaly -diffuse inhomogeneity -multiple splenic nodules (well-defined hypoechoic lesions) are seen.

Spleen involved in all

-systemic inflammations -generalized hematopoietic disorders -many metabolic disturbances

Gaucher's Disease _____ are younger than 1 year of age.

17%

Gaucher's Disease ________ of patients are younger than 8 years of age

50%

Splenomegaly has multiple causes (Box 15-3).

Collagen-vascular disease Congestion Extramedullary hematopoiesis Hemolytic anemia Infection Neoplasm Storage disease Trauma

Gaucher's Disease nodules may be irregular, hyperechoic, or mixed. They represent focal areas of ___________ associated with fibrosis and infarction.

Gaucher's cells

All age groups can be affected by ____________.

Gaucher's disease

____________ is a rapidly progressing fatal disease that predominantly affects female infants.

Niemann-Pick disease

____________ of the spleen are necessary to determine the exact size.

Volume measurements

Two types of splenic congestion are known:

acute and chronic.

In ____________, active hyperemia accompanies the reaction in the moderately enlarged spleen.

acute congestion

In systemic diseases leading to ________, the spleen is the most frequently involved organ.

amyloidosis

Gaucher's Disease follows a chronic course, with________________.

bone pain and changes in skin pigmentation.

Systemic venous congestion is found in _________________ involving the right side of the heart.

cardiac decompensation

In ____________, diffuse enlargement of the spleen occurs.

chronic venous congestion

The most common causes of striking congestive splenomegaly are the various forms of _______ of the liver. It is also caused by obstruction to the extrahepatic portal or splenic vein (e.g., spontaneous portal vein thrombosis).

cirrhosis

If ____________ is present, sonographic findings may be more difficult to obtain.

mild splenomegaly

Two types of involvement are seen: ______________.

nodular and diffuse

In the ________, amyloid is found in the walls of the sheathed arteries and within the follicles, but not in the red pulp.

nodular type

The __________ may be of systemic origin, caused by intrahepatic obstruction to portal venous drainage or by obstructive venous disorders in the portal or splenic veins.

venous congestion