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    Splenomegaly

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    It's AJ
    The document discusses the causes and types of splenomegaly or enlarged spleen. It defines splenomegaly and outlines the major pathophysiological mechanisms that can cause spleen enlargement including infections, disorders of immunoregulation, altered splenic blood flow, lymphohaematogenous malignancies, diseases with abnormal erythrocytes, storage diseases, and miscellaneous causes.

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    Splenomegaly

    Uploaded by

    It's AJ
    49 views17 pages
    The document discusses the causes and types of splenomegaly or enlarged spleen. It defines splenomegaly and outlines the major pathophysiological mechanisms that can cause spleen enlargement including infections, disorders of immunoregulation, altered splenic blood flow, lymphohaematogenous malignancies, diseases with abnormal erythrocytes, storage diseases, and miscellaneous causes.

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    Class PPT on splenomagaly

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    The document discusses the causes and types of splenomegaly or enlarged spleen. It defines splenomegaly and outlines the major pathophysiological mechanisms that can cause spleen enlargement including infections, disorders of immunoregulation, altered splenic blood flow, lymphohaematogenous malignancies, diseases with abnormal erythrocytes, storage diseases, and miscellaneous causes.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    49 views17 pages

    Splenomegaly

    Uploaded by

    It's AJ
    The document discusses the causes and types of splenomegaly or enlarged spleen. It defines splenomegaly and outlines the major pathophysiological mechanisms that can cause spleen enlargement including infections, disorders of immunoregulation, altered splenic blood flow, lymphohaematogenous malignancies, diseases with abnormal erythrocytes, storage diseases, and miscellaneous causes.

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    of 17

    PA 19.

    6 Enumerate and differentiate the


    causes of SPLENOMEGALY

    11/05/2024

    1 Splenomegaly - 11 May 2024


    NORMAL STRUCTURE OF SPLEEN

    Largest lymhoid organ

    Average weight 150 gm in adult

    Well protected by 9th, 10th and 11th ribs in the upper left quadrant

    Covered by a layer of peritoneum

    Ensheathed by a thin capsule underneath peritoneum

    2 Splenomegaly - 11 May 2024


    NORMAL STRUCTURE OF SPLEEN

    From the capsule extend connective tissue trabaculae into the pulp of the organ

    Blood enters the spleen by the SPLENIC ARTERY the branches of which
    penetrate the spleen via trabaculae

    Small branches called CENTRAL ARTERIOLES arise from the trabaculae

    Blood from the central arterioles empties partly into splenic venules and
    splenic vein but largely into vascular sinuses of the red pulp

    3 Splenomegaly - 11 May 2024


    4

    4 Splenomegaly - 11 May 2024


    Fig.- Normal splenic structure
    5

    5 Splenomegaly - 11 May 2024


    NORMAL STRUCTURE OF SPLEEN

    6 Splenomegaly - 11 May 2024


    FUNCTIONS OF THE SPLEEN

    The four major functions of spleen are

    1) It is an organ of the immune system where B and T lymphocytes multiply


    and help in immune responses.

    2)It removes normal and abnormal blood cells by sequestration

    3) It regulates PORTAL BLOOD FLOW through its vasculature

    4) It becomes a site of EXTRAMEDULLARY HAEMATOPOIESIS


    under pathologic conditions

    7 Splenomegaly - 11 May 2024


    SPLENOMEGALY
    Enlargement of the spleen due to a wide variety of disorders which
    increases the cellularity and vascularity of the organ

    The major pathophysiologic mechanisms contributing to splenic


    enlargement are

    1) INFECTIONS
    2) DISORDERED IMMUNOREGULATION
    3) ALTERED SPLEIC BLOOD FLOW
    4) LYMPHOHAEMATOGENOUS MALIGNANCIES
    5) DISEASES WITH ABNORMAL ERYTHROCYTES
    6) STORAGE DISEASES
    7) MISCELLANEOUS CAUSES
    8

    8 Splenomegaly - 11 May 2024


    SPLENOMEGALY
    1) INFECTIONS 2) DISORDERS OF IMMUNOREGULATION

    • Malaria
    • Leishmaniasis • Rheumatoid Arthritis

    • Typhoid • SLE
    • Infectious mononucleosis • Immune haemolytic anaemias
    • Bacterial septicaemia • Immune thrombocytopenias
    • Bacterial Endocarditis • Immune neutropenias
    • Tuberculosis
    • Syphilis
    • Viral hepatitis
    • AIDS 9

    9 Splenomegaly - 11 May 2024


    SPLENOMEGALY

    3) ALTERED SPLENIC 4) LYMPHOHAEMATOGENOUS


    BLOOD FLOW MALIGNANCIES

    • Cirrhosis of liver • Hodgkin’s disease


    • Portal vein obstruction • Non-Hodgkin’s Lymphomas
    • Splenic venous • Multiple myeloma
    obstruction
    • Leukaemias
    • Congestive heart
    • Myeloproliferative disorders like CML
    failure

    10

    10 Splenomegaly - 11 May 2024


    SPLENOMEGALY
    5) DISEASES WITH ABNORMAL 6) STORAGE DISEASES
    ERYTHROCYTES
    • Gaucher’s disease
    • Thalassaemias
    • Niemann-Pick’s disease
    • Spherocytosis
    • Sickle cell disease

    7) MISCELLANEOUS

    • Amyloidosis
    • Primary and metastatic splenic tumours
    • Idiopathic splenomegaly

    11

    11 Splenomegaly - 11 May 2024


    SPLENOMEGALY

    Degree of splenomegaly-
    1. Mild enlargement (upto 5 cm,weight <500g)- Acute malaria,typhoid fever etc.
    2. Moderate enlargement (upto umbilicus,weight 500-1000g))- Hepatitis ,cirrhosis
    etc.
    3. Massive enlargement ( below umbilicus,weight>1000g)-Thalassemia
    major,leishmaniasis etc.

    Massively enlarged spleen may cause dragging sensation in the left hypochondrium

    12

    12 Splenomegaly - 11 May 2024


    Fig.- CVC spleen. Sectioned surface shows that the spleen is heavy and
    enlarged in size.The colour of sectioned surface is grey-tan
    13

    13 Splenomegaly - 11 May 2024


    CONGESTIVE SPLENOMAGLY

    Definition- Congestive splenomegaly refers to the enlargement of the


    spleen due to congestion and increased blood flow,often associated with
    conditions like portal tension

    Causes- It can be caused by various conditions such as cirrhosis of


    liver,congestive heart failure,splenic vein thrombosis and other disorders
    that lead to increased pressure in the splenic circulation

    Pathophysiology- Increased pressure in the portal venous system,often


    seen in liver cirrhosis,leads to portal hypertension.This elevated pressure is
    transmitted to the splenic vein causing congestion and subsequent
    splenomegaly
    14

    14 Splenomegaly - 11 May 2024


    HYPERSPLENISM

    • The term hypersplenism is used for conditions which cause excessive


    removal of erythrocytes,granulocytes or platelets from the circulation
    • It may be due to increased sequestration of cells in the spleen by altered
    splenic blood flow or by the production of antibodies against red blood
    cells
    • It is characterised by splenomegaly,cytopenia,normal or hyperplastic bone
    marrow, and a response to splenectomy
    • After splenectomy,Howell-Jolly bodies are seen in red cells while there is
    leucocytosis and increased platelet counts

    15

    15 Splenomegaly - 11 May 2024


    SOURCES

    1.ROBBINS AND COTRAN PATHOLOGIC BASIS OF DISEASE


    2.TEXTBOOK OF PATHOLOGY BY HARSHMOHAN
    3.EXAM PREPARATORY MANUAL FOR UNDERGRADUATES
    PATHOLOGY BY RAMDAS NAYAK AND RAKSHATHA NAYAK
    4. THE INTERNET

    16

    16 Splenomegaly - 11 May 2024


    THANK YOU
    17

    17 Splenomegaly - 11 May 2024

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