Difference between revisions of "Spleen"
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The '''spleen''' is a forgotten organ. | The '''spleen''' is a forgotten organ. | ||
=Normal histology= | |||
*Capsule. | *Capsule. | ||
*Red pulp - [[red blood cells]]. | *Red pulp - [[red blood cells]]. | ||
*White pulp - white blood cells. | *White pulp - white blood cells. | ||
=Splenic enlargement= | |||
*Portal hypertension (e.g. cirrhosis). | *Portal hypertension (e.g. cirrhosis). | ||
*Lymphoma: | *Lymphoma: | ||
| Line 16: | Line 16: | ||
</ref> | </ref> | ||
=Specific disorders= | |||
==Hyaloserositis== | ==Hyaloserositis== | ||
*Properly referred to as ''hyaloserositis of the spleen''. | *Properly referred to as ''hyaloserositis of the spleen''. | ||
| Line 61: | Line 62: | ||
*[http://commons.wikimedia.org/wiki/File:Littoral_cell_angioma_of_the_spleen_-_very_high_mag.jpg LCA - very high mag. (WC)]. | *[http://commons.wikimedia.org/wiki/File:Littoral_cell_angioma_of_the_spleen_-_very_high_mag.jpg LCA - very high mag. (WC)]. | ||
==See also | =Weird stuff= | ||
*Dendritic cell tumours.<ref name=Ref_WMSP_596>{{Ref WMSP|596}}</ref> | |||
**Interdigitating dendritic cell tumour. | |||
**Follicular dendritic cell tumour. | |||
==Follicular dendritic cell tumour== | |||
*[[AKA]] ''follicular dendritic cell sarcoma''. | |||
===General=== | |||
*Very rare. | |||
*Behave like a low-grade sarcoma.<ref name=pmid9606805>{{Cite journal | last1 = Perez-Ordoñez | first1 = B. | last2 = Rosai | first2 = J. | title = Follicular dendritic cell tumor: review of the entity. | journal = Semin Diagn Pathol | volume = 15 | issue = 2 | pages = 144-54 | month = May | year = 1998 | doi = | PMID = 9606805 }}</ref> | |||
*Reported association with [[Castleman disease]] (hyaline-vascular type).<ref name=pmid9606805/> | |||
===Microscopic=== | |||
Features:<ref name=pmid9606805/> | |||
*Oval or spindle-shaped cellular & nuclear morphology. | |||
*Variable architecture (sheets, fascicles, whorles, storiform pattern). | |||
*Nuclei: | |||
**Small nucleoli. | |||
**Clear or dispersed chromatin. | |||
*Multinucleated cells. | |||
*Interspersed small lymphocytes. | |||
*+/-Necrosis. | |||
*+/-Marked nuclear atypia. | |||
*+/-Abundant mitoses. | |||
===IHC=== | |||
Features:<ref name=pmid9606805/> | |||
*CD21 +ve. | |||
*CD35 +ve. | |||
*Ki-M4p +ve | |||
*Ki-FDRC1p +ve. | |||
*Vimentin +ve. | |||
*S-100 +ve/-ve. | |||
*Muscle-specific actin +ve/-ve. | |||
*EMA +ve/-ve. | |||
=See also= | |||
*[[Haematopathology]]. | *[[Haematopathology]]. | ||
*[[Liver pathology]]. | *[[Liver pathology]]. | ||
=References= | |||
{{reflist|2}} | {{reflist|2}} | ||
=External links= | |||
*[http://www.rcsed.ac.uk/journal/vol47_1/47100010.html Atraumatic rupture of the spleen in adults (rcsed.ac.uk)]. | *[http://www.rcsed.ac.uk/journal/vol47_1/47100010.html Atraumatic rupture of the spleen in adults (rcsed.ac.uk)]. | ||
[[Category:Haematopathology]] | [[Category:Haematopathology]] | ||
Revision as of 14:13, 8 August 2011
The spleen is a forgotten organ.
Normal histology
- Capsule.
- Red pulp - red blood cells.
- White pulp - white blood cells.
Splenic enlargement
- Portal hypertension (e.g. cirrhosis).
- Lymphoma:
- Hairy cell leukemia.
- Splenic marginal zone lymphoma.[1]
- Splenic diffuse red pulp small B cell lymphoma.[2]
- Mononucleosis (EBV infection).
- Hemophagocytic syndrome.[3]
Specific disorders
Hyaloserositis
- Properly referred to as hyaloserositis of the spleen.
- Capsule of the spleen is white - resembles sugar-coating; also known as sugar-coated spleen.[4]
- Importance: none - benign.
Image(s):
Mononucleosis
General
- EBV infection.
- Massive splenic enlargement.
Microscopic
Features:
- Atypical lymphoid cells.
Littoral cell angioma of the spleen
- For angioma see vascular malformations.
General
Features:[5]
- Rare.
- Benign.
- Pyrexia (fever), splenomegaly, weight loss, solitary hypodense lesion on imaging.
Note:
Microscopic
Features:[5]
- Anastoming, small vascular channels.
- Cystic spaces.
- May have papillary projections.[6]
Images:
- LCA - low mag. (webpathology.com).
- LCA - high mag. (webpathology.com).
- LCA - very low mag. (WC).
- LCA - intermed. mag. (WC).
- LCA - very high mag. (WC).
Weird stuff
- Dendritic cell tumours.[9]
- Interdigitating dendritic cell tumour.
- Follicular dendritic cell tumour.
Follicular dendritic cell tumour
- AKA follicular dendritic cell sarcoma.
General
- Very rare.
- Behave like a low-grade sarcoma.[10]
- Reported association with Castleman disease (hyaline-vascular type).[10]
Microscopic
Features:[10]
- Oval or spindle-shaped cellular & nuclear morphology.
- Variable architecture (sheets, fascicles, whorles, storiform pattern).
- Nuclei:
- Small nucleoli.
- Clear or dispersed chromatin.
- Multinucleated cells.
- Interspersed small lymphocytes.
- +/-Necrosis.
- +/-Marked nuclear atypia.
- +/-Abundant mitoses.
IHC
Features:[10]
- CD21 +ve.
- CD35 +ve.
- Ki-M4p +ve
- Ki-FDRC1p +ve.
- Vimentin +ve.
- S-100 +ve/-ve.
- Muscle-specific actin +ve/-ve.
- EMA +ve/-ve.
See also
References
- ↑ Bennett, M.; Schechter, GP. (Apr 2010). "Treatment of splenic marginal zone lymphoma: splenectomy versus rituximab.". Semin Hematol 47 (2): 143-7. doi:10.1053/j.seminhematol.2010.01.004. PMID 20350661.
- ↑ Baseggio L, Traverse-Glehen A, Callet-Bauchu E, et al. (March 2011). "Relevance of a scoring system including CD11c expression in the identification of splenic diffuse red pulp small B-cell lymphoma (SRPL)". Hematol Oncol 29 (1): 47–51. doi:10.1002/hon.957. PMID 20677173.
- ↑ Maakaroun, NR.; Moanna, A.; Jacob, JT.; Albrecht, H. (Mar 2010). "Viral infections associated with haemophagocytic syndrome.". Rev Med Virol 20 (2): 93-105. doi:10.1002/rmv.638. PMID 20127750.
- ↑ URL: http://www.drugs.com/dict/sugar-coated-spleen.html. Accessed on: 1 September 2010.
- ↑ 5.0 5.1 5.2 5.3 Tan, YM.; Chuah, KL.; Wong, WK. (Jul 2004). "Littoral cell angioma of the spleen.". Ann Acad Med Singapore 33 (4): 524-6. PMID 15329769. http://www.annals.edu.sg/pdf200408/V33N4p524.pdf.
- ↑ 6.0 6.1 Dascalescu, CM.; Wendum, D.; Gorin, NC. (Sep 2001). "Littoral-cell angioma as a cause of splenomegaly.". N Engl J Med 345 (10): 772-3. doi:10.1056/NEJM200109063451016. PMID 11547761. http://www.nejm.org/doi/full/10.1056/NEJM200109063451016.
- ↑ URL: http://www.merriam-webster.com/dictionary/littoral. Accessed on: 24 July 2011.
- ↑ URL: http://dictionary.reference.com/browse/littoral. Accessed on: 24 July 2011.
- ↑ Humphrey, Peter A; Dehner, Louis P; Pfeifer, John D (2008). The Washington Manual of Surgical Pathology (1st ed.). Lippincott Williams & Wilkins. pp. 596. ISBN 978-0781765275.
- ↑ 10.0 10.1 10.2 10.3 Perez-Ordoñez, B.; Rosai, J. (May 1998). "Follicular dendritic cell tumor: review of the entity.". Semin Diagn Pathol 15 (2): 144-54. PMID 9606805.