Illustrated Pathology of the Spleen

by Bridget S. Wilkins , Dennis H. Wright

• ISBN13: 9780521622271
• ISBN10: 0521622271
• Format: Hardcover
• Copyright: 2000-03-28
• Publisher: Cambridge University Press

Summary

The major aim of this book is to de-mystify splenic pathology for non-specialist consultants and trainees in histopathology. The interpretation of pathological changes in the human spleen provides a significant challenge to the skills of even the most highly trained histopathologists. This comprehensive account of the most important and frequently encountered pathological conditions affecting the spleen is highly illustrated in colour throughout with numerous detailed macroscopic and microscopic specimens. Emphasis is placed upon the importance of adequate clinical information and technical preparation of splenectomy specimens in obtaining the best possible histopathological assessment of the tissue. A systematic, analytical approach to interpretation of pathological changes is used throughout the book. This should enable readers to feel confident in their assessment of significant processes within the spleen. This volume serves as an illustrated atlas, a bench manual, as a text, and as a source of reference, and will be an indispensable guide.

Table of Contents

Preface	ix
Acknowledgements	xi
Introduction	1	(12)
Why is splenectomy performed?	1	(2)
Why is splenic pathology perceived to be difficult?	3	(2)
What does the surgeon or physician want from the pathologist?	5	(1)
What information does the pathologist require?	6	(1)
How can fixation and processing be optimized to give the best possible histology?	7	(2)
Ancillary investigations	9	(1)
Splenic biopsy, fine needle aspiration and laparoscopic splenectomy	10	(1)
Implications of splenectomy for the patient	11	(1)
Summary	12	(1)
References	12	(1)
Normal structure, development and functions of the spleen	13	(22)
Anatomy and vascular supply	13	(1)
Normal micro-anatomy of the spleen	14	(3)
Development of the spleen during embryonic and fetal life	17	(2)
Functional correlates of red and white pulp structure	19	(4)
Abnormalities of splenic function	23	(1)
Hyposplenism	24	(1)
Hypersplenism	25	(2)
An immunohistochemical inventory of the spleen	27	(4)
References	31	(4)
Post-traumatic and incidentally removed spleens	35	(12)
Introduction	35	(1)
Speens removed incidentally and those removed following trauma are different	35	(2)
An approach to analysis of traumatized or incidental splenectomy specimens	37	(3)
Reactive changes in individual compartments of the spleen	40	(3)
Spontaneous rupture of the spleen	43	(1)
References	44	(3)
The spleen in hereditary blood cell abnormalities and auto-immune disorders	47	(16)
Introduction	47	(1)
Vaccination before splenectomy	48	(1)
Sickle cell anaemia and thalassaemias	49	(2)
Hereditary spherocytosis and auto-immune blood cell destruction	51	(1)
The nature of HS, AIHA and ITP	52	(1)
Macroscopic appearances of the spleen in HS, AIHA and ITP	53	(1)
Red pulp	54	(1)
White pulp	55	(1)
Felty's syndrome	56	(1)
Systemic lupus erythematosus	57	(2)
Polyarteritis nodosum	59	(1)
References	59	(4)
The spleen in immunodeficiency and systemic infections	63	(14)
Inherited immunodeficiency syndromes	63	(2)
Acquired immunodeficiency due to drugs or irradiation	65	(1)
Acquired immunodeficiency syndrome and the spleen	66	(4)
Systemic infections involving the spleen in immunocompetent individuals	70	(4)
References	74	(3)
Lymphomas involving the spleen	77	(34)
Introduction	77	(1)
B cell small lymphocytic lymphoma/chronic lymphocytic leukaemia (B-CLL)	78	(4)
B-prolymphocytic leukaemia	82	(1)
Mantle cell lymphoma (MCL)	82	(3)
Follicle centre cell lymphoma	85	(2)
Splenic marginal zone lymphoma	87	(4)
Lymphoplasmacytoid lymphoma/immunocytoma	91	(1)
Hairy cell leukaemia	92	(3)
Large B cell lymphomas	95	(1)
T cell prolymphocytic leukaemia	96	(1)
Large granular lymphocyte leukaemia, T cell and NK cell types	97	(3)
Splenic T cell lymphoma with erythrophagocytosis	100	(1)
Hepatosplenic γδT cell lymphoma	100	(1)
Hodgkin's disease	101	(4)
Nodular lymphocyte and histiocyte predominant Hodgkin's disease (nodular L&H HD)	105	(1)
References	106	(5)
The spleen in myeloproliferative disorders	111	(14)
Splenic extramedullary haemopoiesis	111	(6)
Systemic mastocytosis	117	(4)
Transient abnormal myelopoiesis in association with Trisomy 21 (Down's syndrome)	121	(1)
The spleen in acute myeloid and lymphoblastic leukaemias	122	(1)
References	122	(3)
Pathology of the splenic stroma	125	(26)
Splenic granulomas	125	(1)
Storage disorders involving cordal macrophages	126	(10)
Langerhans' cell histiocytosis	136	(1)
Splenic pseudotumours and true stromal tumours	137	(4)
Peliosis of the spleen	141	(3)
Splenic vascular hyalinosis	144	(1)
Portal hypertension and the spleen	144	(1)
Splenic infarction	145	(2)
Gamna--Gandy bodies	147	(1)
References	147	(4)
Metastases and miscellaneous conditions	151	(12)
Appearances and primary origins of metastatic cancers involving the spleen	151	(1)
Hamartomas	152	(1)
Splenic cysts and false cysts	153	(1)
Amyloidosis	154	(1)
Congenital anomalies of splenic size, number or anatomical position	155	(1)
Splenunculi and splenosis	156	(1)
Splenic atrophy and fibrosis	157	(2)
Peri-splenitis (`sugar-icing' of the spleen)	159	(1)
Autolysis in splenic tissue	160	(1)
References	161	(2)
Summary: some key points in splenic differential diagnosis	163	(18)
Introduction	163	(1)
Reactive spleen or neoplastic lymphoid proliferation?	163	(10)
Granulomas and cordal macrophage disorders	173	(3)
Extramedullary haemopoiesis-is it significant or not?	176	(1)
References	177	(4)
Index	181