Page 161 - Essential Haematology

Chapter 10 Spleen / 147

Table 10.1 Causes of splenomegaly. Table 10.2 Causes of hyposplenism and

blood fi lm features.
Haematological

Chronic myeloid leukaemia * Causes Blood fi lm features
Chronic lymphocytic leukaemia
Splenectomy Red cells
Acute leukaemia
Sickle cell disease Target cells
Lymphoma *

Essential Acanthocytes
Primary myelofi brosis *
thrombocythaemia Irregularly contracted
Polycythaemia vera
Adult gluten - induced or crenated cells
Hairy cell leukaemia
enteropathy Howell – Jolly bodies

Thalassaemia major or intermedia * Dermatitis (DNA remnants)
Sickle cell anaemia (before splenic infarction) herpetiformis Siderotic (iron)
Haemolytic anaemias Rarely granules
Megaloblastic anaemia infl ammatory bowel (Pappenheimer
Portal hypertension disease bodies)
splenic arterial
Cirrhosis White cells
thrombosis
Hepatic, portal, splenic vein thrombosis ± Mild lymphocytosis,

Storage diseases monocytosis
Gaucher ’ s disease * Platelets
Niemann – Pick disease ± Thrombocytosis
Histiocytosis X
Systemic diseases
Sarcoidosis
Amyloidosis
Collagen diseases – systemic lupus

erythematosus, rheumatoid arthritis Table 10.3 Indications for splenectomy.
Systemic mastocytosis
Splenic rupture
Infections
Chronic immune thrombocytopenia
Acute: septicaemia, bacterial endocarditis,
typhoid, infectious mononucleosis Haemolytic anaemia (some cases), e.g.
Chronic: tuberculosis, brucellosis, syphilis, hereditary spherocytosis, autoimmune
malaria, leishmaniasis, * schistosomiasis * haemolytic anaemia, thalassaemia major or

intermedia

Tropical *

Possibly caused by malaria Chronic lymphocytic leukaemia and lymphomas
Primary myelofi brosis
* Possible causes of massive ( > 20 cm) splenomegaly.

Tropical splenomegaly