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| Congestion |
| Etiology • Any abnormality leading to elevated splenic vein pressures • Cirrhosis of the liver with portal hypertension, heart failure with systemic venous hypertension, portal or splenic vein thrombosis • Sepsis may result in acute congestion of spleen |
| Pathogenesis • Elevated venous pressure results in higher sinusoidal pressures • Fibroses over time with increased pressure, |
| Epidemiology • Common finding in patients with congestive heart failure (up to 500 g) or cirrhotic liver disease |
| General Gross Description • Enlarged reddish purple spleen • Longer the spleen is congested the more firm it becomes |
| General Microscopic Description • Red pulp sinusoids filled with blood • Over time fibrosis of the sinusoid walls secondary to increased pressures with dilatation • Hemosiderin deposition following RBC destruction in dilated sinusoids • Nodules of hemosiderin-laden macrophages with calcium deposition and fibrosis are Gandy-Gamma nodules |
| Clinical Correlation • Enlarged spleen is vulnerable to trauma • Persistent enlargement may lead to RBC destruction |
| References • Cotran RS, Kumar V, Robbins SL: Robbins Pathologic Basis of Disease. 5th edition. Philadelphia, W.B. Saunders, 1994, pp. 670. |
| Congestion |
| Synopsis by: Melinda Sanders M.D. (T07000M36100)[413] |
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