SPLENIC PATHOLOGY

CHAPTER 9 SPLENIC PATHOLOGY

Spenunculus / accessory spleens
Splenic ‘cysts’
Splenogonadal fusion
Splenectomy for hypersplenism
Immune thrombocytopenic purpura (ITP)
Hemolytic anemia [congenital (eg spherocytosis) or acquired]
Congestive splenomegaly
Other miscellaneous splenic disease
Storage disease
Infection
Involvement by malignancy
Sickle cell disease
Spleen in immunodeficiency

INTRODUCTION

• Spleen may be involved with many systemic processes
image most are covered in other sections
• Lesions addressed here are those splenic conditions not encountered elsewhere in the text
• In general, splenic pathology forms a small component of most pediatric surgical pathology workload
image spleen may also be removed following trauma

SPENUNCULUS / ACCESSORY SPLEENS (Fig 9.1)

• Often removed as incidental findings
image usually asymptomatic
• May enlarge following splenectomy for other indication
• No specific histological features
image

Fig 9.1 Photomicrograph of a splenunculus, demonstrating an encapsulated nodule of otherwise unremarkable splenic tissue.

SPLENIC ‘CYSTS’

• The majority of nonparasitic splenic cysts in children are squamous lined epidermoid cysts (Czauderna et al 2006)
• Other rarer types include splenic pseudocyst or mesothelial cyst
image hemangioma or lymphangioma are also described
– often diagnosed as ‘cysts’ preoperatively

Pseudocysts

• Dense fibrosis tissue in wall
image no identifiable epithelial lining
• Usually contain blood and necrotic debris

Epithelial cysts (Figs 9.2–9.5)

• Usually solitary
• Usually present in childhood
image incidentally
image mass lesion
• Cyst wall lined by bland epithelium
image squamous
image columnar
image cuboidal
– possibly derived from epithelial inclusions
image

Fig 9.2 Macroscopic photograph of a spleen resected with a simple epithelial cyst; residual clear/yellow fluid is seen.

image

Fig. 9.3

image

Fig. 9.4

image

Figs 9.3–9.5 Photomicrographs of simple epithelial splenic cysts, demonstrating lining which is focally attenuated and predominantly simple squamous in type, with surrounding fibrosis and otherwise normal splenic tissue.

Parasitic

• Echinococcus infection
image rare in UK

SPLENOGONADAL FUSION

• Usually incidental finding

Related posts:

  1. BONE PATHOLOGY
  2. HEAD AND NECK PATHOLOGY
  3. RENAL PATHOLOGY
  4. TUMORS AND TUMOR-LIKE LESIONS

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Jun 18, 2016 | Posted by in PEDIATRICS | Comments Off on SPLENIC PATHOLOGY

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