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

Ninety-eight patients with clinically localised Hodgkin's disease underwent laparotomy and splenectomy to determine the extent of microscopic spread. In 68 patients the procedure was carried out for untreated disease apparently confined above the diaphragm. Abdominal disease cannot be confidently excluded on the basis of non-invasive investigation at presentation. Clinical assessment of splenic disease was unreliable unless gross splenomegaly was present. Pedal lymphography was accurate in assessing para-aortic and iliac disease but of no value in assessing other intra-abdominal lymph node involvement, including that of the mesenteric lymph node. Trephine bone marrow biopsy findings were normal in all patients before surgery, and only one patient was found to have diseased bone marrow by Stryker-saw biopsy at operation. Liver disease was identified at operation in nine patients, some of whom were asymptomatic with clinically undetectable splenic and nodal disease. Detailed clinical staging failed to detect disease in one-third of patients who underwent laparotomy. These studies show that if radiotherapy is to remain the treatment of choice for disease truly localised to lymph nodes a detailed staging procedure, including laparotomy and splenectomy, remains essential. The value of this potentially curative treatment is considerably diminished in the patient who has been inadequately staged.
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PMID:Intensive investigation in management of Hodgkin's disease. 100 Feb 27

Computed tomography is a very useful method in the diagnosis of splenopathy--any anomalies, inflammatory, neoplastic as well as traumatic states of the spleen. Although these processes are not too frequent, their correct determination is an important part of radiodiagnosis. Computed tomography is so far the best method used for the identification of the congenital varieties of the spleen that may be mistaken, in another examination, for a pathological process of an adjacent organ. In the study a total of 185 pathological spleen findings was evaluated. These were obtained from the total of 18,960 CT examinations of the abdomen. The most frequent finding was splenomegaly (69.2%), less frequent were haematomas and splenic cysts (12.4%) and congenital varieties of the spleen (8.1%). Sporadically, splenic infarction (2.7%), thrombosis of the splenic vein (3.8%), tumour (2.2%) and splenic abscess (1.6%) were demonstrated.
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PMID:Computed tomography of the spleen. 249 Oct 4

Splenomegaly confirmed by surgery or necropsy in 100 dogs was diagnosed histologically as benign neoplasia (n = 1), primary splenic malignancy (n = 59), neoplastic metastases (n = 6), and nonneoplastic disease (n = 34). Dogs with known systemic disease, such as lymphoma and mast cell tumor, that caused splenomegaly were not included in the study. Hemangiosarcoma was the most common splenic disease (43 cases). Overall mean age of the dogs was 10.7 years, the most common breed was German Shepherd dog, and 72 of the dogs weighed more than 21 kg. Dogs with anemia, nucleated red blood cells, abnormal red blood cell morphology, or splenic rupture had a significantly greater chance of having splenic neoplasia (P less than 0.002). A multivariable logistic regression analysis found that the presence of anemia and splenic rupture in dogs with splenomegaly was up to 69% accurate in predicting presence of splenic neoplasia. After splenectomy, the median survival time of dogs with splenic neoplasia was 13 weeks. For dogs with nonneoplastic splenomegaly it was at least 36 weeks.
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PMID:Splenomegaly in dogs. Predictors of neoplasia and survival after splenectomy. 277 49

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

Measurements were made on sulfur colloid scintigrams of normal pediatric livers and spleens by analyzing 131 scans from 116 patients referred for liver or spleen trauma. Studies were used only if scans were normal, there was no history of malignancy or hepatic or splenic disease either prior to of after the study. Linear correlation was made with age, weight and both age and weight. All measured parameters correlated better with weight than with age, with vertical liver dimension exhibiting the best correlation (r = 0.848). Multivariate analysis demonstrated uniformly better correlation of all measurements with both age and weight. Spleen and liver volumes were calculated assuming simple geometry, and showed excellent correlations. Graphical presentation of data will be useful in the clinical determination of hepatomegaly or splenomegaly in routine scintigraphy.
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PMID:Normal hepatic and splenic size in children: scintigraphic determination. 360 58

In patients with hematological malignancies and splenomegaly, acute abdominal pain in the left upper quadrant is highly suspicious of splenic disease (i.e., hematoma, infarction, or rupture). We report the case of a patient with chronic myelogenous leukemia and splenomegaly who presented an unusual abdominal condition causing pain in the left upper quadrant, with a clinical presentation mimicking acute splenic disease. The diagnostic dilemma was resolved by ultrasonography, demonstrating a rectus sheath hematoma.
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PMID:Rectus sheath hematoma mimicking acute splenic disease. 622 32

In order to more specifically define splenic abnormalities with gray-scale ultrasound, a prospective study was performed involving 40 patients with splenomegaly and/or diseases of the spleen. The following sonographic patterns were found: (a) uniform splenic sonodensity, equal to that of the liver (normal); (b) uniform splenic sonodensity, less than that of the liver (low sonodensity); (c) focal defect, more dense than adjacent spleen (sonodense and sonolucent perisplenic defects. Each pattern was found to be associated with certain pathologic categories, which formed a basis for the ultrasonic-pathologic classification of splenic disease. With the use of these patterns, a more specific diagnosis of splenic abnormalities may be made.
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PMID:Ultrasonic-pathologic classification of splenic abnormalities: gray-scale patterns. 735 21

The authors reviewed retrospectively 139 splenopathies detected during 432 US examinations of the abdomen in AIDS patients to assess the role of US in correlation with anamnestic-clinical data and histologic findings in 45 cases. Splenomegaly was the main sign of abnormal splenic conditions, since it was present in all the examined patients. Twenty-one cases exhibited focal lesions. Non-Hodgkin's lymphomas were the only kind of neoplastic condition, which were detected in 15% of cases. In 57% of cases splenopathy was correlated with an infective agent, with a marked prevalence of Mycobacteria-i.e., tubercular in 26% and atypical in 22%. In the splenopathies with histologic confirmation which exhibited a focal US pattern (47%), US proved to be useful in assessing splenic involvement, however aspecific its signs, and in its monitoring, especially in the lesions with unexpected colliquative evolution, as in two cases of atypical mycobacteriosis.
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PMID:[Ultrasound aspects in AIDS-related splenic diseases]. 771 87

We report a splenoma associated with an important megakaryocyte sequestration in peliotic sinuses. The diagnosis was done on surgical specimen of splenectomy performed for a painful splenomegaly occurring in a 71-year-old man presenting a primary idiopathic myelofibrosis. Histopathological features of these splenic microvascularization disorders, mainly occurring during hemopathy involving the spleen, are discussed. This case seems to confirm the hypothesis that splenoma could be an acquired splenic disease.
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PMID:[Splenoma with accumulation of megakaryocytes during the course of an idiopathic myelofibrosis]. 815 90

The size of the normal spleen was estimated by CT in 153 children examined with indication unrelated to splenic disease. In each patient the width, thickness, length and volume of the spleen were calculated. Measurements were also normalized to the transverse diameter of the body of the first lumbar vertebra. The spleen underwent significant growth during the first 4 years of life and reached maximum size at the age of 13. There was no differences in splenic volume between boys and girls. Splenic thickness correlated best with normal splenic volume. The strongest correlation was also found between splenic thickness and volume in a group of 45 children with clinically evident splenomegaly. Splenic thickness, an easy-to-use measurement, may be employed in everyday practice to represent splenic volume on CT.
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PMID:CT assessment of normal splenic size in children. 817 41


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