The Spleen and Its Disorders

Published on 04/03/2015 by admin

Filed under Hematology, Oncology and Palliative Medicine

Last modified 04/03/2015

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Chapter 72 The Spleen and Its Disorders

Nathan T. Connell, Susan B. Shurin, Fred J. Schiffman

Management of Splenic Cysts

A 37-year-old woman with no past medical history comes in for evaluation of early satiety and left shoulder pain. She reports that she feels full after only a few bites of any meal and sometimes becomes nauseated and vomits. Physical examination is remarkable for an enlarged nontender spleen. Imaging shows a large splenic cyst.

• Many conditions can lead to cyst formation in the spleen, including parasitic infections, trauma, hemangiomas, and polycystic kidney disease.

• Asymptomatic nonparasitic cysts may be observed with careful attention and development of a plan for intervention should they become symptomatic, rupture, or become infected.

• Symptomatic cysts may require percutaneous drainage with radiologic guidance or sometimes surgical procedures, including partial or total splenectomy.*

• Parasitic cysts should be treated in consultation with infectious disease specialists because the particular parasitic infection, radiologic appearance, and patient comorbidities will guide choice of therapies.

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Figure 72-1 RED BLOOD CELL FINDINGS IN HYPOSPLENISM.

A, Red blood cells with Howell-Jolly bodies. B, Nucleated red blood cell. C, Cells with Pappenheimer bodies. Red blood cells with Howell-Jolly bodies are seen in patients with hyposplenism. The cytoplasmic inclusions (A)

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