Latest Research News on Spleen : May 21

[1] Structure and function of the spleen

The spleen combines the innate and adaptive immune system in a uniquely organized way. The structure of the spleen enables it to remove older erythrocytes from the circulation and leads to the efficient removal of blood-borne microorganisms and cellular debris. This function, in combination with a highly organized lymphoid compartment, makes the spleen the most important organ for antibacterial and antifungal immune reactivity. A better understanding of the function of this complex organ has been gained from recent studies, as outlined in this Review article.

[2] Normal Structure, Function, and Histology of the Spleen

The spleen is the largest secondary immune organ in the body and is responsible for initiating immune reactions to blood-borne antigens and for filtering the blood of foreign material and old or damaged red blood cells. These functions are carried out by the 2 main compartments of the spleen, the white pulp (including the marginal zone) and the red pulp, which are vastly different in their architecture, vascular organization, and cellular composition. The morphology of these compartments is described and, to a lesser extent, their functions are discussed. The variation between species and effects of aging and genetics on splenic morphology are also discussed.

[3] Radiology of the spleen

The spleen is generally not considered a challenge to the radiologist. Most often it poses a problem by anomalies or an irregular but normal contrast enhancement; however, a variety of inflammatory, infectious and neoplastic diseases may involve the spleen. CT and ultrasonography are screening modalities for the spleen. For problem solving, MR imaging can be helpful, especially due to its free choice of the imaging plane and because of the high resolution in contrast MR imaging. Splenic angiography as a diagnostic tool has generally been replaced by CT, ultrasound, or MR and is now used as an interventional method, e. g., in non-surgical management of patients with chronic idiopathic thrombocytopenia or in patients with splenic trauma. This article reviews the radiology of the spleen, including anatomy, embryology, splenomegaly, splenic injury, infarction, cysts, tumors, abscesses, sarcoidosis, and AIDS. Knowledge about the use of different imaging modalities and underlying gross and microscopic pathologic features leads to a better understanding of the radiologic findings.

[4] Splenic Rupture in Plasmodium vivax Malaria: A Case Report from Kuwait

We describe a case of malaria vivax in a 31 year old Afghan male complicated by spontaneous splenic rupture one month after returning from Pakistan. The ruptured and enlarged spleen displaying multiple subcapsular hemorrhages was surgically resected. Malaria was diagnosed by peripheral blood smear. The patient underwent antimalarial therapy with chloroquine and primaquine. While numerous diseases can result in splenic complications, such as splenic rupture malarial infection is known as the most common cause. Consequently, It is recommended that malaria be always considered in all cases of suspected splenic rupture in the differential diagnosis of all acute fevers, especially among those with a history of travel to an endemic area.

[5] Splenic Rupture after Infective Endocarditis by Enterococcus faecalis: Case Report

A 68-year-old male presented with a history of 2 months of fever and also left upper quadrant pain initiated 2 days before admission. Transesophageal echocardiogram demonstrated the presence of two mobile vegetations on the ventricular side of the aortic valve; the largest diameter being 2.1 cm. Enterococcus faecalis was isolated in blood culture after a diagnosis of subacute aortic valve infective endocarditis. He complained of abdominal pain. An abdominal computed tomography scan revealed infarction of the upper region of the spleen (septic embolism). Therapy with penicillin and gentamicin was initiated, but the patient developed symptoms of heart failure that led to a surgical treatment, and aortic bioprosthesis was implanted on day 14. On day 5 postoperatively, the patient developed sudden hemorrhagic shock signs due to splenic rupture and underwent emergency splenectomy. A pathological examination revealed areas of splenic laceration of the capsule, splenic infarction areas, and the absence of abscesses. Splenic rupture is a complication much rarely occurring due to infectious endocarditis caused by E. faecalis.


Reference

[1] Mebius, R.E. and Kraal, G., 2005. Structure and function of the spleen. Nature reviews immunology5(8), pp.606-616.

[2] Cesta, M.F., 2006. Normal structure, function, and histology of the spleen. Toxicologic pathology34(5), pp.455-465.

[3] Robertson, F., Leander, P. and Ekberg, O., 2001. Radiology of the spleen. European radiology11(1), pp.80-95.

[4] Al-Fadhli, M., Al-Fadhli, A.A., Saraya, M. and Qasem, J.A., 2015. Splenic Rupture in Plasmodium vivax Malaria: A Case Report from Kuwait. Journal of Advances in Medicine and Medical Research, pp.1063-1067.

[5] Macedo, T.A., do Amaral Baruzzi, A.C., Alves, F.Q., Hames, R.L., Sampaio, M.C., Garcia, J.C.T. and Furlan, V., 2016. Splenic Rupture after Infective Endocarditis by Enterococcus faecalis: Case Report. Journal of Advances in Medicine and Medical Research, pp.1-4.

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