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
