Splenic histology and histopathology: an update

Kraus, Madeleine D.

doi:10.1016/s0740-2570(03)00024-8

Cited by 41 publications

(24 citation statements)

References 54 publications

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“…If doubt persists, immunohistochemistry for neuroendocrine markers (chromogranin, synaptophysin, and CD56) and lymphoid markers (CD45) establishes the correct diagnosis in most cases. The presence of CD8-staining endothelial cells in the splenic sinuses, which is distinctive 39 can be used diagnostically to confirm the diagnosis of IPAS suspected on cytologic examination. 35 Another case of IPAS was similarly diagnosed as PEN based on the presence of chromogranin, glucagon, gastrin and somatostatin staining of fortuitously sampled pancreatic islet cells.…”

Section: Discussionmentioning

confidence: 99%

Large platelet aggregates in endoscopic ultrasound‐guided fine‐needle aspiration of the pancreas and peripancreatic region: A clue for the diagnosis of intrapancreatic or accessory spleen

Conway

Cook

Samad

et al. 2011

Diagnostic Cytopathology

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Intrapancreatic and intraabdominal accessory spleens (IPIASs) are rarely encountered in endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) biopsies. However, as incidentally discovered IPIAS can mimic a benign or malignant pancreatic neoplasm on imaging studies, a definitive diagnosis made by EUS-FNA can avert an unnecessary surgical intervention or additional radiologic follow-up. We report five cases of intrapancreatic splenules and one case of accessory spleen (AS) in which a definitive diagnosis was made on EUS-FNA. Previously recognized FNA cytomorphologic features of splenic tissue, including ASs and splenosis, are endothelial cells and polymorphous lymphocytes admixed with neutrophils, eosinophils, plasma cells, histiocytes, and lymphoglandular bodies. We describe the additional finding of abundant large platelet aggregates as another distinguishing feature of splenic tissue on FNA. In all six cases, large platelet aggregates were identified along with polymorphous lymphoid cells, lymphoglandular bodies, loose aggregates of endothelial cells and scattered or aggregated bland spindle cells. A review of 10 consecutive cases of EUS-FNA-sampled benign intraabdominal lymph nodes showed that the presence of large platelet aggregates, three-dimensional aggregates of lymphoid cells and of bland slender spindle cells and the absence of follicular germinal cell components (tingible body macrophages and lymphohistiocytic aggregates) are useful in differentiating IPIASs from reactive lymph nodes. Immunoperoxidase stains were useful to confirm a suspected IPIASs by showing CD31-positive acellular flocculent material, consistent with large platelet aggregates and a rich CD8-positive endothelial cell network between CD45-positive lymphoid cells and CD68-positive histiocytes in all six cases.

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Section: Discussionmentioning

confidence: 99%

Large platelet aggregates in endoscopic ultrasound‐guided fine‐needle aspiration of the pancreas and peripancreatic region: A clue for the diagnosis of intrapancreatic or accessory spleen

Conway

Cook

Samad

et al. 2011

Diagnostic Cytopathology

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“…The red pulp constitutes 80-95% of the spleen and performs processes such as blood filtration and removal of abnormal or aged blood cells. (van Krieken & te Velde, 1988;Kraus, 2003).…”

Section: Introductionmentioning

confidence: 99%

Clinicopathological analysis of primary splenic diffuse large B‐cell lymphoma

et al. 2017

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Splenic infiltration is often seen in diffuse large B-cell lymphoma (DLBCL). However, primary splenic DLBCL is rare and studies on its clinicopathological features are limited. We assessed 66 cases of primary splenic DLBCL and 309 control DLBCL, not otherwise specified. Hepatitis C virus antibody prevalence, B symptoms, poor performance status and CD5 positivity differed significantly between the primary splenic DLBCL and control DLBCL groups. Primary splenic DLBCL cases were classified histopathologically into two groups [white pulp pattern (n = 46), red pulp pattern (n = 20)]. Survival analysis showed no difference in overall survival between the primary splenic DLBCL and the control group, but the former had a more favourable progression-free survival. In the examination of primary splenic DLBCL, the white pulp pattern was statistically associated with a lower performance status (2-4), and a lower CD5 positivity than the red pulp pattern. In the survival analysis, the red pulp pattern demonstrated poorer overall survival. Multivariate analysis of overall survival in primary splenic DLBCL cases identified CD5 positivity as an indicator of poor prognosis. Classifying primary splenic DLBCL into white and red pulp patterns was useful in terms of clinicopathological features and overall survival.

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“…Four patterns of splenic pathology were identified: erythroid extramedullary hematopoiesis with erythrophagocytosis, red pulp congestion with plasmacytosis, extramedullary hematopoiesis with red pulp congestion and dyserythropoiesis, and a chronic myelomonocytic leukemia pattern. Kraus 22 concluded that the cellular composition of myelodysplastic syndrome cannot be reliably distinguished from chronic myeloproliferative disorders based on histologic section. We found this to be generally true of all the neoplastic myeloid disorders included in the study, although there were some notable differences including marked eosinophilia in rare cases of chronic myelogenous leukemia, fibrosis and peritrabecular distribution in mastocytosis, increased numbers of immature cells in acute myeloid leukemia and the numerous atypical megakaryocytes seen in chronic idiopathic myelofibrosis.…”

Section: Discussionmentioning

confidence: 99%

Morphologic and immunohistochemical evaluation of splenic hematopoietic proliferations in neoplastic and benign disorders

et al. 2005

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Spleen is a common site of extramedullary hematopoiesis. Extramedullary hematopoiesis seen in nonneoplastic conditions can occasionally be extensive and raise concerns for a myeloid neoplasm. We compared the morphologic and immunohistochemical features of splenic hematopoietic proliferations seen in neoplastic myeloid disorders (eg chronic myeloproliferative disorders, myelodysplastic/myeloproliferative disorders and acute myeloid leukemias) to extramedullary hematopoiesis seen in a variety of reactive conditions. In all, 80 spleen specimens were reviewed. The presence of each marrow-derived lineage, dysplasia and immunohistochemical results were evaluated (CD34, CD117, myeloperoxidase, CD68, p53, TdT, CD42b and hemoglobin). Neoplastic hematopoietic proliferations in chronic myeloproliferative disorders are characterized by trilineage hematopoiesis with significant dysplasia in all cell lineages. Acute myeloid leukemia showed an increase in immature forms, which were highlighted by immunohistochemistry. Reactive extramedullary hematopoiesis showed variability in histologic features. Post-bone marrow transplant and thrombotic thrombocytopenic purpura/hemolytic-uremic syndrome spleens showed extramedullary hematopoiesis with some morphologic features of immaturity, which could simulate chronic myeloproliferative disorder. However, they lacked characteristic immunohistochemical features of neoplastic myeloid disorders such as positivity for CD34 or CD117. Modern Pathology (2005) 18, 1550-1561.

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Splenic histology and histopathology: an update

Cited by 41 publications

References 54 publications

Large platelet aggregates in endoscopic ultrasound‐guided fine‐needle aspiration of the pancreas and peripancreatic region: A clue for the diagnosis of intrapancreatic or accessory spleen

Large platelet aggregates in endoscopic ultrasound‐guided fine‐needle aspiration of the pancreas and peripancreatic region: A clue for the diagnosis of intrapancreatic or accessory spleen

Clinicopathological analysis of primary splenic diffuse large B‐cell lymphoma

Morphologic and immunohistochemical evaluation of splenic hematopoietic proliferations in neoplastic and benign disorders

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