Pathology Associates Of Lexington, P.A.
Pathology Associates Of Lexington, P.A.
Pathology Associates Of Lexington, P.A.
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        Spleen Pathology
      
Splenomegally
[transfusion & coagulopathy issues]
  1. Primarily cirrhosis associated:
  2. Primarily non-cirrhotic associated:
    • increased portal pressure etiology:
      • hepatoportal sclerosis (HPS) (idiopathic portal hypertension)
      • other
    • etiology not increased portal pressure:
      • cellular infiltrates of spleen:
        1. hairy cell leukemia
        2. MDS rarely causes splenomegally unless progresses to leukemia so that leukemiic cellular splenomegally [L09-15620].
        3. lymphoma
          1. systemic hemophagocytic syndrome (SHS)...familial vs. secondary: you see lots of macrophages engulfing hematolymphoid cells).
        4. teenagers with ITP may enlarge the spleen as macrophages engulf the damaged platelets...remindful of Gauches. The histology is some or all of follicular hyperplasia, plasmacytosis, and ceroid histiocyte clusters; these histiocytes usually contain some iron positivity & the appreciation of plasmacytosis enhanced with CD138 stain [L04-8363]. Splenectomy helps in chronic ITP and infusion of platelets and ligation timing important.
      • metabolic/storage or depositional disease in spleen:
        1. amyloidosis
        2. other

References:

(posted 3 November 2004; latest addition 9 April 2007)
 
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