• Cross-section of a spleen showing a congested, dusky interior.
• The white flecks within this tissue represent the white pulp or Malpighian bodies.
• The spleen also appears to be somewhat fibrotic at this power.
• 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
• Elevated venous pressure results in higher sinusoidal pressures
• Fibroses over time with increased pressure
• Common finding in patients with congestive heart failure (up to 500 g) or cirrhotic liver disease
• Enlarged spleen is vulnerable to trauma
• Persistent enlargement may lead to RBC destruction
|General Gross Description|
• Enlarged reddish purple spleen
• Longer the spleen is congested the more firm it becomes
|General Micro 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
• Cotran RS, Kumar V, Robbins SL: Robbins Pathologic Basis of Disease. 5th edition. Philadelphia, W.B. Saunders, 1994, pp. 670.