Other nonneoplastic disorders
Congestive splenomegaly

Author: Jaleh Mansouri, M.D. (see Authors page)

Revised: 2 March 2018, last major update October 2012

Copyright: (c) 2003-2018, PathologyOutlines.com, Inc.

PubMed Search: Congestive splenomegaly spleen

Cite this page: Mansouri, J. Congestive splenomegaly. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/spleencongestivesplenomegaly.html. Accessed July 23rd, 2018.
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