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33 Cards in this Set

  • Front
  • Back
Two components of the spleen
Superomedial and inferolateral
Normal measurements of the spleen
12 length
7 breadth
5 thickness
Differential diagnosis of splenomegaly
Neoplasm infiltration
trauma
storage disorders
Portal hypertension
Causes of mild-moderate splenomegaly
infection, portal hypertension, AIDS
Causes of marked splenomegaly
Leukemia, lymphoma, mononucleosis
Causes of massive splenomegaly
myelofibrosis
What a focal lesion in splenomegaly can mean
lymphomatous involvement
metastatic disease
cysts
hematoma
Can establish portal hypertension as the cause of splenomegaly
Recanalized umbilical vein
Splenic vein varicies
Ascites
Occurence rate of splenomegaly in AIDS patients
50-75%
Appearance of miliary tuberculosis
Common in AIDS pts
Diffuse echogenic foci in the spleen giving it a speckled appearance
Appearance of cysts
Echo free
Smooth sharp borders
Enhancement deep into lesions
Location of small and large cysts
Small-parenchyma
Large-exophtic (outside)
One of the least common sites for the development of the hydatid cyst
Echinococcus (infectious)
Diagnosis of infectious cysts is aided by:
History
Serological tests
Fine need aspiration
Infectious cysts sonographic appearance
Echo free w/ internal echoes
Smooth sharp or irregular borders
Enhancement deep into lesions
Hyperechoic outer ring as the wall is calcified
Sonographic appearance of posttraumatic cysts (pseudocysts)
No cellular lining
Walls may be calcified due to echinococcus
Low level echoes
May have cholesterol crystals or debris
Primary congenital cysts (epidermoid cysts)
Epithelial or endothelial lining will differentiate from postraumatic cyst
Thought to rise from the mesothelial cells
Sonographic appearance of splenic abscesses
Look like simple cysts
Frequently gas in abscess cavity which causes shadowing and ring down
Well defined or irregular borders if encapsulated or ruptured
Solid focal lesions
Uncommon in the spleen
Usually from granulomatous infections
Granulomatous infections are caused by:
histoplasmosis
TB
less commonly sarcoidosis
Sonographic appearance of granulomatous infections
Focal, bright, echogenic
No shadowing
Pseudotumors of the spleen
Rare mass lesions
Reported in the eye, respiratory tract, GI tract, lymph nodes, soft tissues, heart, and liver
Fewer than 70 cases reported
Splenic Calcification
Common, may be mistaken for pathology
Sonographic appearance of lymphomatous infiltration
Discreet
Hypoechoic masses
Replaces splenic tissue
Enlarged hypoechoic nodes initial impression
Metastatic disease in order of most to least common
Malignant melanoma
Lymphoma
Meukemia
Ovary
Breast
Lung
Stomach
Sonographic appearance of hemangiomas
Hyperechoic or mixed echogenicity with cystic spaces
More common cause of splenic infarction
Splenic lesions
Sonographic apperance of splenic infarction
Wedge shaped
Hypoechoic region
On the peripheral of spleen
Lesions become hyperechoic over time (chronic)
Sonographic apperance of hepatosplenic candidiasis
Wheel in wheel
outer wheel-fibrosis
inner wheel-inflammatory cells w/ central necrotic area
May look like a bulls eye
Sonographic appearance of splenunculi
Small round masses less than 5 cm
Near splenic hilum
Splenunculi
Supranumeray spleens
Confused w/ enlarged lymph nodes or masses of pancreas tail
Occur w/ polysplenia
(spleen on both sides)
Two left lungs
Interuppted IVC
Biliary atresia
No GB
Cardiovascular abnormalities
Occur w/ asplenia
(no spleen)
Two right sided lungs
Midline liver
Reversed AO and IVC
Odd pulmonary venous return
Horseshoe kidney
Serious infections