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