Spleen in involved in all systemic inflammation, generalized hematopoetic disorders, and many metabolic disturbances... true or false?
What are the 2 types of splenic congestion?
Acute- Moderately enlarged spleen
Chronic- Diffusely enlarged spleen
Congestion of the spleen causes dilation of the splenic hilum veins associated with ______________.
What is the protein associated with bone marrow that can be abnormally deposited in excess in any tissue or organ?
What is the most frequently involved organ in amyloidosis? What happens with this disease?
Spleen. Amylid builds up in organs.
What are the 2 types of Amyloidosis?
Nodular- Amylid is found in walls of sheathed arteries
Diffuse- Follicles are not involved
Red pulp is involved
Spleen is greatly enlarged and firm
Where can Gaucher's disease occur?
-less commonly in brain
Interferes in normal function of organss
-associated with fibrosis
-diffuse echogenecity of organ
What is a very fast and fatal storage disease that affects mostly female infants?
What are some clinical findings of Neimann-Pick disease?
What is a type of lysosome storage disease?
-Lack of enzymes that normally eliminate unwanted substances in the cells in the body
What are diffuse diseases?
-Sickle Cell Anemia
What contains an abnormal type of hemoglobin and are misshapen red blood cells?
Sickle cell anemia
In acute sickle cell crisis...
...sickle cells can interfere with O2 transport, obstruct cappilary flow and causes severe pain. Splenomegaly and decreased hematocrit.
Congenital Shpherocytisis is what?
Intrinsic abnormality of red cells. RBCs are shaped like spheres instead of discs.
What is polycythemia vera?
Increased RBC production and hemoglobin concentration.
-Excess production of WBCs, RBCs, and platelets.
What is a treatment of polycythemia?
Phlebotomy decreases blood thickness. One pint of blood is removed each week until hematocrit level is less than 45.
What happens with thalassemia?
It is a genetic condition that the spleen is very involved in. The body has difficulty MAKING hemoglobin.
What do cells look like with thalassemia?
Erythrocytes with a central spot of color in the area of pallor, resembling a target.
What are some symptoms of Thalassemia?
Enlarged spleen, heart and liver
What does thalassemia present as sonographically?
-severely enlarged spleen
-appears similar to liver tissue
Sonographically what can granulocytopoietic abnormalities look like?
-diffusely hypoechoic pattern
-Pts with previous infections may have echogenic lesions without shadowing
-calcium may be found in splenic artery
What is letterer-siwe disease?
Proliferation of reticuloendothelial calls in all tissues.
Most commonly seen in pts under 2 years old
What is Hand-Schuller-Christian disease?
Lipids accumulate in the body and manifest as granulomas in bone (particularly in skull), skin, viscera.
What gives wheel-within-wheel patterns?
-Outer wheel represents the ring of fibrosis surrounding the inner echogenic wheel of inflammatory cells and a central hypoechoic area
What is ALWAYS present with splenic infarction?
Peripheral wedge shaped, hypooechoic lesion base towards subcapsular surface.
What are the varied echogenecities that present with splenic infarction?
Fresh- Localized hyperechoic area
Old, healed- hypoechoic
May be nodular
What is most likely the problem?
-Left shoulder pain
-Left flank pain
-Tenderness over LUQ
-Splenomegaly most common finding sonographically