Table of Contents
Definition / general | Treatment | Gross description | Microscopic (histologic) descriptionCite this page: Mansouri J. Congestive splenomegaly. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/spleencongestivesplenomegaly.html. Accessed April 24th, 2024.
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
Treatment
- 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
