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34 Cards in this Set

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spleen specs
150 g; enclosed in thin, glistening, slate-gray CT capsule; extenisve red pulp dotted with gray specs (white pulp follicles)
splenic pulp
artery with eccentric collar of T lymphocytes-expands to form lymphoid nodules composed mainly of B cells
red pulp transversed by
numerous thin-walled vascular sinusoids, separated by splenic cords or 'cords of Billroth'
endothelial lining of sinusoids
discontinuous-provides passage for blood cells btwn sinusoids and cords
cords of spleen contain
labyrinth of macrophages loosely connected through long dendritic processes to create both physical and fxnal filter
spleen 4 fxns that impact disease states
1) phagocytosis of blood cells and particulate matter 2) antiboy production 3) hematopoiesis 4) sequestration of formed blood elements
platelets and speen
normally harbors 30-40% total platelet mass; with splenomegaly up to 80-90% platelet mass can be sequestered in interstices of red pulp producing thrombocytopenia
main bacteria patients susceptible to after splenectomy
pneumococcus, meningococcus, and Haemophilus influenzae
hypersplenism
anemia, leukopenia, thrombocytopenia, alone or in combination; likely due to sequestration and enhanced phagocytosis
nonspecific acute splenitis
occurs in any blood-borne infection
nonspecific acute splenitis morphology
acute congestion of red pulp which may encroach on and virtually eface the lymphoid follicles
congestive splenomegaly
chromic venous outflow obstruction-intrahepatic disorders, extrahepatic disorders impinging on portal or splenic veins, cardiac decompensation, pulmonary
congestive splenomegaly morphology
firm, capsule thickened and fibrous; red pulp congested early, but increasingly fibrotic and cellular with time
bland infarcts of spleen
pale, wedge-shaped, subcapsular in location; overlying capsule often covered with fibrin
septic infarcts of spleen
dvlp suppurative necrosis-in course of healing large, depressed scars often dvlp
most common neoplasm ariseing in spleen
lymphangiomas and hemagiomas-often cavernous type
accessory spleens
20-35% postmortem exams; small, spherical structures histologically identical to normal spleen
where are accessory spleens found
within abdominal cavity
most common predisposing factor to splenic rupture
mono, malaria, typhoid fever, lymphoid neoplasms
thymus dvlps from
3rd and inconstantly 4th pair of pharyngeal pouches
cortical. Epithelial, and peripheral cells in thymus
polygonal in shape and have abundant cytoplasm with dendritic extensions that contact adjacent cells
epithelial cells in medulla of thymus
densely packed, often spindle-shaped, and have scant cytoplasm devoid of interconnecting processes
myoid cells
muscle-like; may play role in myasthenia gravis
DiGerorge syndrome
thymic hypoplasia/aplasia, variable parathyroid dvlp associations; 22q11 deletion syndrome
thymic cysts
usually discovered incidentally
thymic follicular hyperplasia
appearance of B-cell germinal centers within thymus
when is thymic hyperplasia most commonly seen
myasthenia gravis (65-75% cases); sometimes Graves', Lupus, scleroderma, RA, and other autoimmune diseases
thymomas
tumor of thymic epithelial cells
3 histological subtypes of thymomas
1) clinically benign and noninvasive 2) benign, but invasive/metastatic 3) cytologically malignant
morphology of thymoma
lobulated, firm, gray-white masses up to 15-20 cm; sometimes areas of cystic necrosis and calcification; most encapsulated
noninvasive thymomas
medullary-type epithelial cells or mixture with cortical-type epithelial cells; 50% thymomas
invasive thymoma
cytologically benign, locally invasive; usually cortical variety with abundant cytoplasm and rounded vesicular nuclei; 20-25% thymomas
thymic carcinoma
5% thymomas; usually fleshy, most squamous cell carcinomas,
lymphoepithelioma-like carcinoma
rare thymic carcinoma with sheets of cells with indistinct borders-close histological resemblance to nasopharyngeal carcinoma; 50% EBV