Lymph nodes & spleen, nonlymphoma

Spleen-general

Splenectomy, rupture & splenosis



Topic Completed: 1 October 2012

Minor changes: 21 April 2021

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PubMed Search: Splenectomy[TI] spleen[TI] free full text[sb], Spleen rupture[TI], Splenosis[TI] free full text[sb]

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Table of Contents
Splenectomy | Rupture | Splenosis
Cite this page: Mansouri J. Splenectomy, rupture & splenosis. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/spleensplenectomy.html. Accessed October 25th, 2021.
Splenectomy

Definition / general
  • Usually performed for traumatic rupture
  • Usually no clinical consequence in adults but elevated risk of infection is present, especially in elderly and those with malignancy (Med J Aust 2012;196:582)
  • In children, associated with increased incidence and severity of infections, particularly encapsulated bacteria such as Streptococcus pneumoniae, Neisseria meningitidis, Haemophilus influenzae; overwhelming infections (OPSI: overwhelming postsplenectomy infection) may begin days to years after splenectomy, without an identifiable focus and have 50 - 80% mortality despite antibiotics
  • Increased susceptibility to severe infections with intraerythrocytic parasites Babesia and Plasmodium (Clin Microbiol Rev 2010;23:740)
  • In children, splenectomy is avoided in favor of splenic repair, partial splenectomy or splenic autotransplant
  • Must consider possibility of accessory spleen(s) if splenectomy is performed for hematologic disorders

Laboratory
  • Howell-Jolly bodies are evidence of no splenic function

Case reports

Peripheral smear images

Images hosted on other servers:

Howell-Jolly bodies

Rupture

Definition / general
  • Due to blunt trauma or abdominal surgery, causing hemoperitoneum and emergency splenectomy
  • Only rarely ruptures spontaneously (associated with acute splenitis, amyloidosis [rare], infectious mononucleosis, inflammatory disorders, leukemia / lymphoma, malaria, other tumors, peliosis lienis, pregnancy, subacute bacterial endocarditis, typhoid fever)
  • Splenic rupture may be delayed after trivial / minor trauma

Case reports

Clinical images

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Grossly enlarged with hematoma



Gross description
  • Rupture may be a very small capsular tear, often in superior pole or hilum

Microscopic (histologic) description
  • Neutrophils below capsular tear with intraparenchymal hemorrhage; also lymphoid hyperplasia with prominent marginal zone

Additional references
Splenosis

Definition / general
  • Autotransplantation of splenic tissue on peritoneal surface, abdominal wall or elsewhere after rupture or splenectomy
  • Usually affects young men
  • Common; may affect 67% of those with trauma to spleen
  • May also implant within pleural cavity, lung parenchyma or brain

Case reports

Clinical images

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Autotransplantation
spleen tissues



Microscopic (histologic) description
  • Red and white pulp, resembling accessory spleen

Differential diagnosis
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