Spleen

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The spleen is a forgotten organ.

Normal histology

Splenic enlargement

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.

Clinical:[5][6]

  • Pyrexia (fever), splenomegaly, weight loss, solitary hypodense lesion on imaging.

Note:

  • Littoral cells = line vascular channels of the red pulp.[5]
    • Littoral = related to shore.[7][8]

Microscopic

Features:[5]

  • Anastoming, small vascular channels.
  • Cystic spaces.
    • May have papillary projections.[6]

DDx:[5]

Images:

IHC

Features:[5]

  • CD68 +ve.
  • CD31 +ve

Splenic hamartoma

General

  • Benign.
  • Women > men.[9]

Microscopic

Features:[10]

  • Variable size irregular vascular channels
  • Red pulp-like disorganized stroma
  • +/-Lymphoid follicles.

IHC

Features:[10]

  • CD8 +ve endothelial cells.

Weird stuff

  • Dendritic cell tumours.[11]
    • Interdigitating dendritic cell tumour.
    • Follicular dendritic cell tumour.

Follicular dendritic cell tumour

  • AKA follicular dendritic cell sarcoma,[12] dendritic reticulum cell sarcoma, (???) follicular dendritic cell neoplasm. (???)

General

Microscopic

Features:[13]

  • 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 - distinctive feature.
  • +/-Necrosis.
  • +/-Marked nuclear atypia.
  • +/-Abundant mitoses.

Images:

IHC

Features:[13]

  • 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

  1. 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.
  2. 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.
  3. 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.
  4. URL: http://www.drugs.com/dict/sugar-coated-spleen.html. Accessed on: 1 September 2010.
  5. 5.0 5.1 5.2 5.3 5.4 5.5 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. 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.
  7. URL: http://www.merriam-webster.com/dictionary/littoral. Accessed on: 24 July 2011.
  8. URL: http://dictionary.reference.com/browse/littoral. Accessed on: 24 July 2011.
  9. Sankar, S.; Thanka, J.; Jagdishchandrabose, S.; Rajendran, S.. "Splenic hamartoma: a rare vascular space occupying lesion of the spleen.". Indian J Pathol Microbiol 54 (1): 223-5. doi:10.4103/0377-4929.77416. PMID 21393931.
  10. 10.0 10.1 Lee, H.; Maeda, K. (Jan 2009). "Hamartoma of the spleen.". Arch Pathol Lab Med 133 (1): 147-51. doi:10.1043/1543-2165-133.1.147. PMID 19123729.
  11. 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.
  12. 12.0 12.1 Leipsic, JA.; McAdams, HP.; Sporn, TA. (Jun 2007). "Follicular dendritic cell sarcoma of the mediastinum.". AJR Am J Roentgenol 188 (6): W554-6. doi:10.2214/AJR.04.1530. PMID 17515347.
  13. 13.0 13.1 13.2 13.3 Perez-Ordoñez, B.; Rosai, J. (May 1998). "Follicular dendritic cell tumor: review of the entity.". Semin Diagn Pathol 15 (2): 144-54. PMID 9606805.

External links