Spleen, organ of the lymphatic system located in the left side of the abdominal cavity under the diaphragm, the muscular partition between the abdomen and the chest. In humans it is about the size of a fist and is well supplied with blood. As the lymph nodes are filters for the lymphatic circulation, the spleen is the primary filtering element for the blood. The organ also plays an important role in storing and releasing certain types of immune cells that mediate tissue inflammation.
The spleen is encased in a thick connective-tissue capsule. Inside, the mass of splenic tissue is of two types, the red pulp and the white pulp, which do not separate into regions but intermingle and are distributed throughout the spleen. The white pulp is lymphoid tissue that usually surrounds splenic blood vessels. The red pulp is a network of splenic cords and sinusoids (wide vessels) filled with blood, and it is in the red pulp that most of the filtration occurs.
- Enlarged Spleen (Splenomegaly): An enlarged spleen, usually caused by viral mononucleosis (“mono”), liver disease, blood cancers (lymphoma and leukemia), or other conditions.
- Ruptured spleen: The spleen is vulnerable to injury, and a ruptured spleen can cause serious life-threatening internal bleeding and is a life-threatening emergency. An injured spleen may rupture immediately after an injury, or in some cases, days or weeks after an injury.
- Sickle cell disease: In this inherited form of anemia, abnormal red blood cells block the flow of blood through vessels and can lead to organ damage, including damage to the spleen. People with sickle cell disease need immunizations to prevent illnesses their spleen helped fight.
- Thrombocytopenia (low platelet count): An enlarged spleen sometimes stores excessive numbers of the body’s platelets. Splenomegaly can result in abnormally few platelets circulating in the bloodstream where they belong.
- Accessory spleen: About 10% of people have a small extra spleen. This causes no problems and is considered normal.
- Physical examination: By pressing on the belly under the left ribcage, a doctor can feel an enlarged spleen. They can also look for other signs of illnesses that cause splenomegaly.
- Computed tomography (CT scan): A CT scanner takes multiple X-rays, and a computer creates detailed images of the abdomen. Contrast dye may be injected into your veins to improve the images.
- Ultrasound: A probe is placed on the belly, and harmless sound waves create images by reflecting off the spleen and other organs. Splenomegaly can be detected by ultrasound.
- Magnetic resonance imaging (MRI): Magnetic waves create highly detailed images of the abdomen. By using contrast dye, blood flow to the spleen can also be measured with MRI.
- Bone marrow biopsy: A needle is inserted into a large bone (such as the pelvis) and a sample of bone marrow is taken out. Leukemia or lymphoma, which cause splenomegaly, are sometimes diagnosed by bone marrow biopsy.
- Liver and spleen scan: A small amount of radioactive dye is injected into the arm. The dye moves throughout the body and is collected in both of these organs.
- Splenectomy: The spleen is removed by surgery, either through laparoscopy (multiple small incisions) or laparotomy (one large incision).
- Vaccinations: After spleen removal, it’s important to get vaccinations against certain bacteria, such as H. influenza and S. pneumonia. An absent spleen increases vulnerability to these infections.
Conditions That Affect The Spleen
- Bacterial, viral, and parasitic infections such as syphilis, tuberculosis, endocarditis, mononucleosis (mono), and malaria
- Blood cancers such as Hodgkin’s disease, leukemia, and lymphoma
- Liver diseases like cirrhosis
- Hemolytic anemia
- Metabolic disorders like Gaucher’s disease and Niemann-Pick disease
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