Illustrated Pathology of the Spleen Bridget S
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Cambridge University Press 0521622271 - Illustrated Pathology of the Spleen Bridget S. Wilkins and Dennis H. Wright Index More information Index Note: page numbers in italics refer to figures and tables. abscess cystic change 153 formation in spontaneous rupture 43 metastasis; differential diagnosis 152 mycotic 152 subdiaphragmatic 159 tuberculous 152 acanthocytes 24 acquired immune deficiency syndrome (AIDS) 66–70 bacillary angiomatosis 69–70 CD8-positive T cells 67–8 Kaposi’s sarcoma 141 leishmaniasis 73, 175 opportunistic infection 68–70 tumours 70 white pulp atrophy 68 see also human immunodeficiency virus (HIV) infection actin see alpha-smooth muscle actin (␣-SMA) acute leukaemia 122 acute lymphoblastic leukaemia 122 immunohistochemistry 122, 123 acute megakaryoblastic leukaemia (AML), AML-M7 subtype 121 acute myeloid leukaemia 122, 169 immunohistochemistry 122, 123 alpha-smooth muscle actin (␣-SMA) 16, 17, 21 PALS dendritic network 30 spindle cells 30, 32 amyloid staining 144 types A and L 155 amyloid tumour 154 amyloidosis 154–5 anatomy of spleen 4, 13–17 angioma cystic change 153 littoral cell 140–1 181 © Cambridge University Press www.cambridge.org Cambridge University Press 0521622271 - Illustrated Pathology of the Spleen Bridget S. Wilkins and Dennis H. Wright Index More information Index 182 angiomatosis migration 22–3 bacillary 69–70 red pulp 22 diffuse 139–40 white pulp 22–3 angiosarcoma 140–1, 141–3 B-prolymphocytic leukaemia 82 Thorotrast-induced 159 bacillary angiomatosis 69–70 ankyrin 52 bacteria, encapsulated 11 anticoagulant therapy, spontaneous rupture 43 bacterial endocarditis 147 antigen presentation site 16 splenic atrophy 158 antigen retrieval methods 9 band 3 52 antigen-presenting cells (APC) 22 barrel hoop fibres 16 apoptosis 23 Bartonella henselae 69–70 atrophy of spleen 23, 157–9 bcl-2 86, 87 due to Thorotrast exposure 158–9 bilateral spleen 155 in HIV infection 68 biochemical analysis 9 in sickle cell anaemia 50 biopsy 10–11 auto-antibodies Birbeck granules 137, 138 blood cell coating 52 blast cells 40, 42 in non-Hodgkin’s lymphoma 53 in acute leukaemia 122 auto-immune cytopenia 26 in Epstein–Barr virus infection 71 auto-immune haemolytic anaemia (AIHA) 2, 6, 47, 51–2 in lymphoplasmacytoid lymphoma 92 atrophy of spleen 157 in marginal zone lymphoma 90 causes 52–3 in mast cell leukaemia 120 cordal macrophages 54, 57 blood cells erythrocytosis 25 reservoir 5 erythrophagocytosis 54, 56 see also red cells; sequestration incidental EMH 178 blood lakes, hairy cell leukaemia 94–5, 97, 98, 173 intrasinusoidal red cell phagocytosis 54–5, 56 blood supply see vascular supply of spleen macroscopic appearance of spleen 53 bone marrow hyperplasia 25 microscopic features 56, 60 Bruton’s X-linked agammaglobulinaemia 64, 65 white pulp changes 55–6 Burkitt’s lymphoma 77 autolysis, splenic 160–1 post-mortem 73–4 cancers metastasis sources 152 B cell lymphocytic lymphoma (B-CLL) 77, 78, 79–80, routes of spread 151 81–2 capsular damage 6 chromosome deletions 81, 82 capsule 14 distinction from mantle cell lymphoma 83 cassettes, for fixation 8 genetic features 81–2 cat spleen 5 IgG gene mutations 81–2 cat-scratch disease 69 immunophenotype 81 CD4-positive T cells 15, 16 para-immunoblasts 78, 80, 81 AIDS 68 trabecular infiltration 167 CD8 expression 15, 16 trisomy 12 81, 82 CD8-positive T cells, AIDS 67–8 B cell lymphoma CD68 expression 20 nodular lymphocyte and histiocyte predominant centroblasts 27 Hodgkin’s disease 105 in follicle centre cell lymphoma 86, 89 see also lymphoma; large B cell lymphoma; small B cell centrocytes 23, 27 lymphoma in follicle centre cell lymphoma 89 B cells 15 ceroid 131, 134, 135 in inherited immunodeficiency states 64–5 accumulation 127, 175, 176 marginal zones 28, 29 ceroid histiocytes 128 © Cambridge University Press www.cambridge.org Cambridge University Press 0521622271 - Illustrated Pathology of the Spleen Bridget S. Wilkins and Dennis H. Wright Index More information 183 Index ceroid histiocytosis 55, 126, 130, 131, 134, 135 differential diagnosis 163 chemotherapy, cytotoxic 66 analytical approach 163 chronic granulocytic leukaemia (CGL) 114 cordal macrophage disorders 173, 175–6 chronic lymphocytic leukaemia (CLL) 164, 168 EMH 176–7, 178 hilar lymph nodes 172 germinal centres 164, 165, 166 mantle zones 166, 167 granulomas 173, 175–6 circulatory pathways hilar lymph nodes in splenic lymphoma closed/open 19, 20 171–2 fast transit 26 macrophages 175–6 red pulp 19, 20 mantle zones 166 closed circulation see circulatory pathways marginal zones 167 coeliac disease 158 peri-arteriolar lymphoid sheaths (PALS) 168 congenital absence of spleen 24 red pulp 169 congenital anomalies 155–6 diffluent spleen 74 connective tissue trabeculae 40 DiGeorge’s syndrome 64 cordal macrophages 20, 21 dog spleen 5 differential diagnosis of disorders 173, 175–6 Down’s syndrome see trisomy 21 in AIHA 54, 57 drug therapy, acquired immunodeficiency 65–6 in ceroid histiocytosis 135 Dutcher bodies 91, 92, 167 in HS 54, 55 dyserythropoiesis 47 in ITP 55, 58 in malaria 72 Echinococcus 154 in Niemann–Pick disease 130, 131 ectopia, splenic 156 pitting 24, 50 elderly patients, spleen size 39–40 platelet phagocytosis 55 embolism, spontaneous rupture 43 storage disorders 26, 126–8, 129, 130–1, 132–4, 135–6 endothelial cells cords of Billroth see splenic cords immunohistochemistry 31, 34 corticosteroids 6 in angiosarcoma 140, 141, 142, 143 in acquired immunodeficiency 65 in haemangioma 139, 140 in auto-immune disorders (AIHA+ITP) 56 in hereditary spherocytosis (HS) 54 in Felty’s syndrome 57 in littoral cell angioma 140, 141 in systemic lupus erythematosus 59 in lymphangioma 139, 140 tingible body macrophages 136 in Niemann–Pick disease 130, 132 white pulp microscopic changes 56 red pulp 41, 43 Crohn’s disease 158 in storage disorders 127 cryptococcosis 68–9 see also sinusoidal endothelium cyclin D1 85, 86 epithelial inclusion cysts 153–4 cystic lesions 154 epithelioid granulomas 125, 173 cysts 153–4 Hodgkin’s disease 173, 175 cytogenetic analysis 9 see also granulomas cytopenia Epstein–Barr virus (EBV) infection 44, 70–1 auto-immune 26 in autolysed tissue 161 peripheral blood 25 erythrocytes in incidental EMH 112 cytoplasmic inclusions erythrocytosis, secondary 25 ceroid histtocytoses 131 erythroid cells, dysplastic in significant extramedullary Gaucher’s disease 130 haemopoiesis (EMH) 115 Niemann–Pick disease 130, 132, 133 erythroid precursors 115, 160 erythrophagocytosis in AIHA 54, 56 dendritic cells, follicular 27 essential thrombocythaemia (ET) 114, 115, 117 description of spleen 7, 8 peliosis 118 development of spleen 17–19 Evans’ syndrome 47, 51, 53 © Cambridge University Press www.cambridge.org Cambridge University Press 0521622271 - Illustrated Pathology of the Spleen Bridget S. Wilkins and Dennis H. Wright Index More information Index 184 experimental animals 5 marginal zone differentiation 86, 168 haemopoiesis 18 mutations 87 extra-follicular focus, white pulp 22–3 red pulp 171 extramedullary haemopoiesis (EMH) 18, 111–15, 116, white pulp nodules 86, 88, 165 117 follicular dendritic cells 27 cytology 177 differential diagnosis 176–7, 178 Gamna–Gandy body 59, 145, 147, 148 distribution 177 foreign body giant cells 147, 148 incidental 18, 112–13, 176, 177, 178 perisplenitis 159, 160 causes 113–14 Gaucher’s cells 128, 129, 130, 175 megakaryocytes 111 Gaucher’s disease 126, 127–8, 129, 130 primitive myeloid cells 112–13 germinal centres 14, 15 significant 114–15, 116, 117, 178 atrophy in X-linked hyper-IgM syndrome 65 associated diseases 114 differential diagnosis 164, 165, 166 differential diagnosis 176, 177, 178 fibrinoid necrosis 74 subtypes 111 immunohistochemistry 27–8 extramedullary haemopoietic cells in autolysed tissue in post-traumatic spleen 36 160–1 involution 43 reactive changes 39 false cysts 153–4 glucosyl ceramide degradation enzyme deficiency 127 Felty’s syndrome 56–7, 97 granulocytes in EMH 177, 178 atypical 57 in incidental EMH 112–13 red pulp 61 granulomas 125–6 fibrinoid necrosis caseating 125–6 germinal centres 74 cystic change 153 malaria 72 differential diagnosis 173, 175–6 systemic lupus erythematosus 59 in Hodgkin’s disease 104, 105 fibrocongestive splenomegaly 145, 146 in selective IgA deficiency 64–5 fibrosis 157–9 red pulp 173, 175 in malaria 72 sarcoid-like 125–6 in systemic mastocytosis 119, 120 white pulp 173, 175 in Thorotrast-induced atrophy 159 see also epithelioid granulomas onion-skin 59 granulomatous inflammation 125–6 fibrous histiocytosis, malignant 141 granulopoietic cells in autolysis 160 fine needle aspiration cytology 10 fixation 3–4, 7–9 haemangioma 139–40, 152–3 optimization 7 haematoma partial 3, 4, 8 intrasplenic 38 primary 4 subcapsular 8 secondary 3 haemoglobin abnormalities 49–51 fixative sickle cell anaemia 49 penetration 3, 4 thalassaemias 50 follicle centre cell lymphoma (FCCL) 77, 78, 85–7, 88–9, haemolytic anaemia see auto-immune haemolytic 164, 165 anaemia (AIHA) bcl-2 86, 87 Haemophilus influenzae type B vaccination 6–7, 11, 48 centroblasts 86, 89 haemopoiesis, splenic 18 centrocytes 89 see also extramedullary haemopoiesis (EMH) differential diagnosis 86 haemopoietic cells genetic features 87 extramedullary 160–1 hilar lymph nodes 172 immunohistochemistry 123 immunophenotype 86–7 haemopoietic function in embryonic/fetal life 17–18 © Cambridge University Press www.cambridge.org Cambridge University Press 0521622271 - Illustrated Pathology of the Spleen Bridget S. Wilkins and Dennis H. Wright Index More information 185 Index haemopoietic lineages, antibodies reactive with 123 histoplasmosis