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Query: UMLS:C0038002 (splenomegaly)
 9,873 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In 5 patients with portal hypertension caused by schistosomiasis, the sinusoidal pressure (wedged hepatic pressure) varied from 20.7 to 35.4 mm Hg. While the catheter was in an occluded position within the hepatic vein and the patients were undergoing splenectomy, the main trunk of the hepatic artery was clamped. The sinusoidal pressures then fell to levels that varied from 3.7 to 7.4 mm Hg but returned to previous levels when the clamping was released. Wedged hepatic venous pressure levels, which were significantly greater than portal venous pressure values, decreased minimally after splenectomy. Portal venous pressure levels, however, fell to 63% of presplenectomy levels. In a control case with an enlarged spleen (cavernous hemangioma, but with a normal liver, the wedged hepatic pressure was 7.4 mm Hg and showed no alteration after clamping of hepatic artery. These data point out the importance of hepatic artery hypertrophy, that has already been demonstrated in other studies, in causing elevation of the wedged hepatic pressure in advanced hepatic schistosomiasis.
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PMID:Hepatic artery hypertrophy and sinusoidal hypertension in advanced schistosomiasis. 31 79

Splenic cavernous haemangioma is a rare cause of splenomegaly. It is a benign tumour which has seldom been diagnosed pre-operatively, because the clinical presentation is usually atypical. This is reflected in a patient who presented with splenomegaly, and in whom cavernous haemangioma of the spleen was diagnosed only after operation.
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PMID:Cavernous haemangioma of the spleen. A case report. 86 84

Lymphangiomas of the spleen are infrequent neoplasms of the spleen with clinical manifestations ranging from insignificant incidental findings to large, symptomatic cystic masses requiring surgical intervention. An associated syndrome may be lymphangiomatosis, in which the lymphangiomatous process involves other sites or organs, such as the liver, spleen, axilla, and mediastinum. Vasoformative neoplasms (hemangioma, lymphangioma) are relatively uncommon tumors or hamartomas of the spleen. Although well reported in the literature, their surgical significance is not well recognized. These lesions present a broad spectrum of pathologic findings of varied surgical importance. As incidental findings, they may be mistakenly considered as a valid indication for splenectomy. On the contrary, more extensive involvement of the spleen may cause symptomatic splenomegaly, which is a valid indication for splenectomy. When the spleen is diffusely involved (lymphangiomatosis), it may be part of a syndrome of generalized lymphangiomatosis involving structures and organs other than the spleen. This syndrome should be considered in obscure cases of splenomegaly in which the usual hematologic causes have been ruled out.
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PMID:The clinical spectrum of lymphangiomas and lymphangiomatosis of the spleen. 141 32

Haemangioma is the commonest non-malignant tumour of the spleen. Cytopenia and coagulopathy, secondary to cell trapping and coagulation factors consumption inside the haemangioma, respectively. May occasionally occur as accompanying phenomena. A woman is presented who had splenic haemangioma associated with leucopenia and thrombocytopenia along with decrease fibrinogen and prolonged prothrombin time as well as low complement rates. She had massive splenomegaly with portal hypertension, and the partial oxygen pressure values in mesenteric and portal blood were concurrent with the presence of arteriovenous shunts. The leucocyte and platelet count, the serum complement, the fibrinogen rate and the prothrombin time recovered after splenectomy. The cavernous characteristics of the spleen, containing multiple thrombi, were confirmed upon scanning electron microscope examination. The pathophysiology of the cytopenias and clotting factors consumption is discussed, stress being laid on the ultrastructural findings. A review is presented of the clinical aspects, differential diagnosis and treatment.
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PMID:[Cavernous hemangioma of the spleen with a localized intravascular coagulation syndrome (Kasabach-Merritt syndrome). Ultrastructural study]. 162 Nov 86

This report concerns 172 patients with sonographically diagnosed benign and malignant splenic lesions. A variety of echopatterns was observed, but a differential diagnosis was often impossible without contributory clinical data. Thirteen patients underwent ultrasound-guided fine-needle biopsy for histological confirmation or therapy. In 14 cases splenectomy was performed for treatment or final diagnosis. Twenty-three patients had malignant space-occupying lesions of the spleen. 26 cases presented with normal splenic size, 47 showed splenomegaly of different extent. Lymphoma was the main basic illness in 60 patients. Thirteen cases presented with splenic metastases from other neoplasms. 71 malignant splenic lesions were hypoechoic when compared with normal splenic echotexture. Only two patients exhibited hyperechoic metastases. In three cases a 'halo' sign was seen. In 99 patients benign focal lesions of the spleen were diagnosed. These included splenic infarction (n = 36), dysontogenetic cysts (n = 23), splenic abscesses (n = 7), splenic calcification (n = 13), and hyperechoic lesions (n = 17) most probably representing splenic hemangioma.
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PMID:Splenic lesions: sonographic patterns, follow-up, differential diagnosis. 188 32

We present a young asymptomatic woman with splenomegaly and a large isolated splenic mass demonstrated by ultrasonography, 99mTc sulfur colloid, and gallium scintigraphy studies. Computerized tomography (CT) and three-phase 99mTc-labeled red blood cell imaging suggested a malignant lesion. Repeated sonographically guided fine needle aspiration (FNA) obtained only blood, suggesting the possible vascular nature of the tumor. Splenectomy established the diagnosis of splenic hemangioma (SH) with marked sclerotic changes. We conclude from this case that 1) the sclerotic and cystic changes in the SH and the abdominal lymphadenopathy could explain why the three-phase red blood cell and CT scanning, respectively, suggested that the lesion was malignant rather than benign; 2) guided FNA of a splenic mass suspected to be hemangioma may be an additional safe and useful diagnostic procedure. Multiple aspirations yielding blood alone suggest hemangioma and may prevent an unnecessary operation. To the best of our knowledge, this is the first reported case in the literature of FNA of splenic hemangioma.
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PMID:Difficult preoperative diagnosis of a patient with sclerosing splenic hemangioma. 254 95

Hemangioendothelioma is seldom seen in adults. Its severe evolution is due, not so much to the exceptional transformation into hemangiosarcoma, but mainly to haemorrhagic complications by rupture or consumption coagulopathy and to severe cardiac insuffficiency secondary to arteriovenous shunts. The case reported here concerns a 64 year-old woman presenting pain in the left hypochondrium and splenomegaly. A splenectomy was performed and the histological findings were compatible with the diagnosis of hepato-splenoganglionic hemangioendothelioma. The evolution was unfavorable. The patient died a few months later in a picture of haemorrhagic syndrome and cardiac insufficiency. Histological findings on autopsy specimens indicated a cavernous hemangioma. The treatment of these diffuse hemangiomas is a difficult one. Hepatic artery ligation has been advocated in certain desperate situations. Nevertheless, because of a collateral circulation, recurrences are frequent.
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PMID:[Lymph node-hepatosplenic hemangioma in an adult with consumption coagulopathy and fatal cardiac insufficiency]. 343 34

Imaging procedures have lately become important in pathologic conditions of the spleen, because they are simple to use and do not cause much stress to the patient. Ultrasonography is the method of choice for determination of the position, shape, size and volume of the spleen, and also for the diagnosis of changes within the spleen. Circumscribed lesions cannot be detected by ultrasonography until they have reached a size of 0.5-1.0 cm; the same limit of detection applies for CT, which has approximately the same diagnostic reliability. In the presence of generalized splenic disease (e.g. splenomegaly in myeloid leukaemia) imaging procedures are being used increasingly for staging and for monitoring of the results of treatment. Perhaps in future histochemical determinations made with the aid of core-spin spectroscopy will present a further means of diagnosis without the necessity for biopsy. Angiography was the leading diagnostic technique for spleen conditions for many years, and continues to occupy this place for primary disease of the spleen (aneurysm, arterioportal fistula, haemangioma); it is currently gaining in importance with the advent of therapeutic embolization as an option. For diffuse spleen disease and also for circumscribed lesions, however, it has now been superseded by the non-invasive methods of diagnosis.
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PMID:[Modern imaging procedures in splenic diseases]. 355 34

Cutaneous hemangiomas are frequently found on routine clinical examination and generally are not important. But when internal organs are involved, these vascular tumours assume greater importance because of associated morbidity. A case is presented of multiple organ involvement by angiomas in a woman with a history of flank hemangioma who was investigated for hematuria and splenomegaly. She subsequently underwent splenectomy. The uncommon systemic syndromes characterized by vascular tumours are discussed, and the case reported is appropriately classified. The clinical picture, pathologic features and investigations appropriate for systemic cystic angiomatosis are briefly reviewed. The authors recommend conservative management when there is splenic involvement unless the size of the spleen makes its rupture likely or when there are hematologic complications.
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PMID:Systemic cystic angiomatosis in a woman with hematuria and splenomegaly. 360 42

The authors review the symptomatology of splenic tumor pathologies in connection with 93 personal observations (71 non-Hodgkin lymphomas, 12 Hodgkin's disease, 6 metastases, 3 epidermoid cysts, 1 angioma). Nodular forms were observed in 31.2% of the cases reviewed. In most cases of lymphoma, the ultrasonographic finding was a homogeneous splenomegaly. The possibility of false negatives for splenic involvement in lymphomas when spleen volume is normal has led certain authors to suggest fine needle puncture of the spleen under ultrasonographic guidance. Such procedures are unnecessary if ultrasonography has detected an obvious lesion such as multinodular involvement of homogeneous splenomegaly. However, this moderately traumatic technique can provide valuable information until such time as ultrasonic tissue characterization has proven itself in vivo.
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PMID:[Echography in tumor pathology of the spleen: limitations and perspectives]. 666 34


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