Other nonneoplastic disorders
Congestive splenomegaly

Topic Completed: 1 October 2012

Minor changes: 18 March 2019

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PubMed Search: Congestive splenomegaly spleen

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Cite this page: Mansouri J. Congestive splenomegaly. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/spleencongestivesplenomegaly.html. Accessed May 30th, 2020.
Definition / general
  • Caused by portal hypertension, which may be due to Budd-Chiari syndrome (thrombosis of hepatic veins), cirrhosis, congestive heart failure, portal vein stenosis, thrombosis of splenic veins, other thrombosis
  • Portal vein thrombosis may be due to inflammation, inflammatory induced extrinsic pressure, trauma, tumor or idiopathic
  • Portal vein stenosis may be due to extension of obliterative process at birth in umbilical vein and ductus venosus into portal vein
  • Banti syndrome: idiopathic portal hypertension; controversial entity, cases in Japan and India, associated with fibroelastosis in portal tracts, dilated capillaries, phlebosclerosis; associated with hypersplenism and anemia, leukopenia and thrombocytopenia
  • Splenectomy:
    • No shunt needed if coronary vein joins portal system central to point of obstruction; otherwise shunt is needed
    • Possible shunts include splenic vein to renal vein, portal vein to vena cava
Gross description
  • Large, firm, dark with fibrosis of capsule
Microscopic (histologic) description
  • Dilated veins and sinuses, fibrosis of red pulp, hemosiderin laden macrophages
  • Iron and calcium containing fibrotic nodules (Gamna-Gandy bodies) secondary to hemorrhage
  • No prominent lymphoid follicles
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