Abdomen- Spleen
Accessory spleens are most often located ?
At the hilum of the spleen
The MOST common focal neoplasm found in the spleen is a:
Cavernous hemangioma
Etiologies for congestive splenomegaly can include all of the following ?
Cirrhosis, cystic fibrosis, splenic thrombosis. Expect for polycythemia Vera .
Which one of the following are indications for a sonogram of the spleen?
Clinical history of mononucleosis, anemia, erythrocytosis.
What are the risk factors associated with splenic infarction?
Gaucher disease , bacterial endocarditis, portal hypertension.
Another name for splenoma is ?
Hamartoma
You are performing an abdominal ultrasound scan and detect a hypoechoic, wedge-shaped lesion within the spleen. This typical appearance of which of the following entities?
Splendid infarction.
What is associated with this history of blunt trauma?
Splenic laceration , subcapsular hematoma of the spleen , free fluid, perisplenic hematoma .
Which structure will you detect at the splenic hilum ?
Splenic vein.
An averaged size male patient has been referred for ultrasound evaluation of splenomegaly. What transducer would provide the highest resolution images of the spleen?
5.0 MHz curved linear array.
Which one of the following is NOT an indication for a sonogram of the spleen?
Abnormal phosphate .
During routine sonographic evaluation of the spleen, you detect a small, rounded mass the splenic hilum that is homogeneous and Isoechoic with the spleen. You have most likely detected:
Accessory spleen.
You are performing an ultrasound study on a patient with a history of recent blunt left-sided trauma in a motor vehicle accident. Which finding below is not associated with this history?
Calcified splenic cyst.
All of the following are functions of the spleen
Destruction of red blood cells , production of lymphocytes, production of plasma cells.
What is not a risk factor associated with splenic infarction?
Diabetes mellitus
The spleen in a patient with leukemia will most likely be :
Enlarged
During abdominal sonography of a patient with portal hypertension and splenomegaly, you detect a calcified ring at the splenic hilum. What should you do?
Evaluate the area with color Doppler. These findings are consistent with splenic artery aneurysm.
Which of the following would be most helpful in improving diagnostic confidence in the case described in the above question?
Evaluate the lesion with color Doppler. An area of infarction will not show color Doppler signals because the spleen is highly vascular.
In the question above, considering the ultrasound findings, what additional information should you provide?
Evaluate the liver and portal vein.
A patient presents with upper left quadrant pain. An abdominal sonogram reveals a complex mass in the spleen with free fluid in the abdominal /pelvic cavity. This most likely represents:
Hematoma
Which term can be used to describe the normal sonographic appearance of the splenic parenchyma?
Homogeneous with mid to low -level echogenicity.
Which of the following is not a feature you would detect in a splenic cyst?
Increased attenuation.
A sonogram of the spleen demonstrates a hypoechoic , wedge-shaped area in the peripheral aspect. This is most likely consistent with
Infarction
You have been asked to evaluate the tail of the pancreas. What relationship of the pancreatic tail to the spleen ?
Inferomedial, the pancreatic 'til approaches the spleen at the splenic hilum.
You are examining the spleen during routine sonography. What view provides the best long axis image of the spleen?
Intercostal coronal view with patient supine.
Which of the following is a pitfall you might encounter in ultrasound scanning of the spleen?
Intercostal scanning may produce shadows obscuring the splenic parenchyma, in hepatomegaly, the left lobe of the liver may be mistaken for the spleen. A mass in the pancreatic tail may be confused with a splenic mass. An accessory spleen may be confused with an enlarged lymph node.
The sonographic appearance of a normal spleen in relationship to the liver is ?
Isoechoic or hypoechoic and homogeneous
In adults with a history of sickle cell anemia, the spleen is typically:
Small in size.
You are performing an ultrasound study on a patient with malignant melanoma. Your ultrasound findings reveal multiple hyperechoic masses within the spleen. This most likely represents:
Metastasis.
You are imaging the spleen of a 27 year old male with AIDS. What is the most common finding in the spleen in patients with AIDS?
Moderate splenomegaly.
You are performing an ultrasound on a patient with histoplasmosis. What findings of the spleen are commonly seen in this condition?
Multiple focal, bright echogenic granulomatous lesions throughout the spleen. Remember this pattern may be seen with tuberculosis and sarcoidosis involving the spleen
Which congenital splenic disorder is associated with visceral heterotaxy of bilateral left-sidedness ?
Polysplenia syndrome.
An enlarged spleen may be caused by:
Portal hypertension
You are scanning a patient with moderate splenomegaly. Which of the following is a cause of mild to moderate splenomegaly?
Portal hypertension , infection, AIDS.
During splenic sonography, you detect moderate splenomegaly and dilated , tortuous vessels at the splenic hilum. What condition do you suspect?
Portal hypertension.
The splenic vein drains into what vein ???
Portal vein
This is not a function of the spleen?
Production of enzymes
What is not true regarding the spleen?
The spleen is NOT a retroperitoneal structure. The spleen is located intraperitoneally.
What is also true about the spleen?
The spleen is located in the left upper quadrant, the spleen lies between the fundus of the stomach and diaphragm, the average adult spleen measures 12 cm in length, the normal spleen decreases in size and weight with advancing age.
You are performing a abdominal ultrasound and are having difficulty identifying the spleen. Which of the following structures is in contact with the spleen?
The structures that are in contact with the spleen are left hemidiagraphm, stomach, pancreas, splenic flexure of the colon.
