Histopathological study and audit of the spleen in Nigerians

Abstract

SUMMARYStudies on the spleen in Nigerians are rare. This study reviewed retrospectively the gross and histopathological findings in spleens received at the histopathology laboratory of the Obafemi Awolowo University Hospital (OAUTHC), Ile-Ife, Nigeria. 119 consecutive splenectomy specimens received within a period of 18 years were analysed with respect to age, sex, pathological diagnoses and indication for splenectomy. There were 76 males and 43 females with a mean age of 34.8 years (STD 19.6 years). Spleen weight, size, the presence of malarial parasite as well as fibrosis was not documented in many cases. The most frequent finding both grossly and microscopically was haemorrhagic necrosis from laceration of the spleen arising from trauma (62.7% of all cases). Road traffic accident (RTA) accounted for 86% of all trauma cases and was the predominant finding in both sexes up to the age of 50 years. Thereafter, haematological malignancy was the predominant finding in the spleen. Chronic lymphocytic leukaemia (CLL) was the most common haematological malignancy in the spleen. The indications for splenectomy correlated well with the histological findings (kappa=0.81). Pathological description of spleen specimens is inadequate. Trauma is the major reason for splenectomy. In elderly Nigerians, splenectomy specimen would likely show CLL.

Histomorphological Pattern of Splenectomy Specimens: A FiveYear Study in a Tertiary Teaching Hospital

“…The higher incidence in this age group may be related to greater predisposition to traumatic injury in this age group. The age and gender distribution are close to the reported series in the literature [3,8,9] . The most common histopathological findings in our study were haemorrhagic necrosis and capsular disruption as a result of splenic laceration in road traffic accidents and blunt trauma.…”

“…In the present study, two specimens of traumatic rupture showed increased blackish brown pigments mimicking malarial pigments but definite malarial parasite could not be detected. In other studies predisposing factors like malaria, amyloidosis, follicular hyperplasia etc were detected in cases of ruptured spleen [3,8,9].…”

Clinicopathological features of splenectomy specimens: Experience of 16 years

“…Ancak literatürde splenektomi materyallerinin klinikopatolojik özelliklerini konu alan az sayıda çalışma bulunmaktadır. Ülkeler arasında ve yaşa göre sırala-mada farklılıklar olmakla birlikte, en sık splenektomi endikasyonları arasında travmaya bağlı rüptür, hematolojik hastalıklar, infeksiyonlar ve batın içi diğer organ patolojileri nedeniyle uygulanan operasyonlarda prosedür gereği yapılanlar ilk sıralarda yer almaktadır (3,4,7,8) . Çalışmamızda da benzer durumlar splenektomi endikasyonlarının büyük çoğunluğunu oluşturmakta-dır.…”

“…Normal bir erişkinde dalak ortalama 150-200 g ağırlığında ve 12x7x3 cm boyutlarında-dır (1) . Abdomende bulunduğu lokalizasyon, anatomik olarak koruyucu bir kemik kafese sahip olmadığından travmalara sekonder incinmelere son derece yatkın-dır (3) . Splenektominin en sık endikasyonları arasında; derece 4-5 dalak travması, masif splenomegalisi olanlarda dalak büyüklüğüne ait semptomların kontrolü, dalağın kist ve tümörleri, hematolojik hastalıkların tanı ve tedavisi yer almaktadır (4) .…”

Potency of Curcuma aeruginosa as A Chemopreventive Candidate Agent on 7,12-Dimethylbenz[a]anthracene (DMBA)-Induced Rat Spleen

“…Chemoprevention study on spleen was carried out because the spleen is the largest organ of the mononuclear phagocyte system and is involved in all systemic inflammation (Adelusola, Osasan, & Afolabi, 2008;Jiang, Ma, & Liu, 2018). The chemoprevention effect of C. aeruginosa on the spleen is an indicator how the active compound from the plant suppresse or prevents either the initial phases of carcinogenesis or the progression of cancer.…”