MyMedR

Splenic Pseudotumor-Like Follicular Dendritic Cell Sarcoma

Lim JY, Hong SK, Huang WF

J Gastrointest Surg, 2023 Jul;27(7):1486-1488.

PMID: 36849606 DOI: 10.1007/s11605-023-05630-y

Matched MeSH terms: Spleen

Anomalous splenic notches: a cadaveric study with clinical importance

Das S, Abd Latiff A, Suhaimi FH, Ghazalli H, Othman F

Bratisl Lek Listy, 2008;109(11):513-6.

PMID: 19205563

To study the anomalous splenic notches and discuss their clinical importance.

Matched MeSH terms: Spleen/abnormalities*; Spleen/anatomy & histology

Fulltext Angiosarcoma of the liver

Khoo JJ

Med J Malaysia, 2002 Jun;57(2):233-6.

PMID: 24326660

A 47-years-old Malay man presented with unremitting epigastric pain and loss weight for 3 months. At laparotomy, a large tumour mas was found in the liver and a few small nodules in the spleen. Histopathological examination revealed a hepatic angiosarcoma with metastsis to the spleen. He had exposure to formic acid fumes for more than 23 years in his work as a rubber tapper. The various chemical carcinogens that are implicated in this type of tumour are discussed. The possiblity of an association between formic acid fumes and development of angiosarcoma in the liver is highlighted.

Matched MeSH terms: Spleen

Fulltext Spontaneous splenic rupture in Plasmodium knowlesi malaria

Chang CY, Pui WC, Kadir KA, Singh B

Malar J, 2018 Dec 04;17(1):448.

PMID: 30509259 DOI: 10.1186/s12936-018-2600-2

BACKGROUND: Plasmodium knowlesi, a malaria parasite typically found in long-tailed and pig-tailed macaques, is the most common cause of human malaria in Malaysian Borneo. Infections in humans result in a spectrum of disease, including fatal outcomes. Spontaneous splenic rupture is a rare, but severe complication of malaria and has not been reported previously for knowlesi malaria.

CASE PRESENTATION: A 46-year-old man presented with fever and acute surgical abdomen with concomitant P. knowlesi malaria infection at Kapit Hospital. He was in compensated shock upon arrival to the hospital. He had generalized abdominal tenderness, maximal at the epigastric region. Bedside focused abdominal ultrasonography revealed free fluid in the abdomen. He underwent emergency exploratory laparotomy in view of haemodynamic instability and worsening peritonism. Intraoperatively, haemoperitoneum and bleeding from the spleen was noted. Splenectomy was performed. Histopathological examination findings were suggestive of splenic rupture and presence of malarial pigment. Analysis of his blood sample by nested PCR assays confirmed P. knowlesi infection. The patient completed a course of anti-malarial treatment and recovered well post-operation.

CONCLUSIONS: Spontaneous splenic rupture is a rare complication of malaria. This is the first reported case of splenic rupture in P. knowlesi malaria infection. Detection of such a complication requires high index of clinical suspicion and is extremely challenging in hospitals with limited resources.

Matched MeSH terms: Spleen/parasitology; Spleen/physiopathology

Fulltext Management of isolated splenic injuries after blunt trauma: an institution's experience over 6 years

Tan KK, Chiu MT, Vijayan A

Med J Malaysia, 2010 Dec;65(4):304-6.

PMID: 21901951

Forty-two patients with traumatic blunt splenic injuries were admitted over a six year period. Vehicular-related collisions and fall from height accounted for the injuries in 38 (90.5%) of them. Eleven (26.2%) underwent immediate surgery (7 splenectomy and 4 splenorrhaphy), while the remaining 31 patients were treated nonoperatively of which 3 underwent angio-embolisation. Twenty seven patients had either grade III or IV splenic injuries. Operative management was more likely in patients with lower haemoglobin or with more severe splenic injury. Nonoperative management can be adopted in patients with blunt isolated splenic injuries but operative management is still indispensable in certain instances.

Matched MeSH terms: Spleen/injuries*; Spleen/surgery

Fulltext Torsion of a wandering spleen with whorled appearance of the splenic hilum in CT scan

Thambidorai CR, Imtiaz A, Nafiqudin M

Med J Malaysia, 2005 Dec;60(5):653-4.

PMID: 16515121

An eight-year-old boy admitted for acute abdominal pain was diagnosed to have torsion of the spleen (TS) based on contrast enhanced computerised tomography (CECT) of the abdomen. CECT showed whorled appearance in the splenic hilum. Whorl sign' refers to the presence of a twisted splenic pedicle intermingled with fat, resulting in alternating circular bands of radiodensity and radiolucency and is considered diagnostic of TS. This is the fourth reported case of whorl sign in children with TS and the first from Malaysia.

Matched MeSH terms: Wandering Spleen/radiography*

The diagnosis of nutritional megaloblastic anaemia: the use of bone marrow biopsy

TASKER PW

Med J Malaya, 1957 Dec;12(2):395-405.

PMID: 13515870

Matched MeSH terms: Spleen*

Identification of immune-related genes by analysis of spleen expressed sequence tags from the Asian seabass, Lates calcarifer

Nurul-Yuziana Mohd-Yusof, Hoh CC, Adura Mohd-Adnan, Wan KL

Sains Malaysiana, 2009;38.

The Asian seabass (Lates calcarifer) is one of the most economically important aquaculture fish species in South East Asia. While the biology of the Asian seabass is widely studied, relatively little information is available at the molecular level. This lack of molecular information represents one obstacle to rapid progress in the study of immune responses particularly under aquaculture conditions. In light of this situation, we have undertaken an expressed sequence tag (EST) project on the Asian seabass spleen, the secondary lymphoid organ, for the identification of immune-related genes. A
total of 2932 ESTs were generated and grouped into 1063 unique transcripts (UTs), which consisted of 104 consensi and 959 singletons. Of these, 51.3% (545/1063) matched to previously identified genes, while 48.7% (518/1063) showed no match. Of the 545 homologous UTs, 102 (9.6%) can be putatively identified as immune-related genes. The identification of the putative immune-related genes provides a meaningful framework in the effort to comprehend the Asian seabass immune system that may lead to an increase in the understanding of the defense mechanisms of and our abilities to
manage this fish species.

Matched MeSH terms: Spleen

Partial control of malaria in a localized area by plasmoquine

Baeza JI

Journal of the Malaya Branch of the British Medical Association, 1939;2:239-43.

Matched MeSH terms: Spleen

Fulltext Splenorrhaphy: omental pouch

Lazim TR, Salleh M, Bakar AS

Med J Malaysia, 1995 Jun;50(2):145-9.

PMID: 7565184

This work studies the efficacy of an autogenous viable omental pouch as a means of splenorrhaphy for saving the traumatised spleen. One sheep and 9 goat spleens were mobilised and their vascular pedicles clamped. All spleens were subjected to AAST grade IV trauma. The injured spleens were put into omental pouches and manual pressure was applied for 10 minutes after removal of the vascular clamp. Bleeding was controlled in 8 animals which became fully active 12-36 hours postoperatively. Two animals died, one due to aspiration of gastric contents during surgery and the other due to bleeding 24 hours postoperatively. All remaining spleens were harvested after 6 weeks. They were surrounded by a fibrous capsule and the previously inflicted injuries were easily identifiable. Viable omental pouch based on left epiploic vascular pedicle offers itself as a good autogenous alternative other methods used for saving the injured spleen. This method has been used in two humans so far.

Matched MeSH terms: Spleen/injuries*

Further stages of the "sporozoan" from the moon rat Echinosorex gymnurus, and its possible connection with Sarcocystis

Dissanaike AS, Lim BL, Poopalachelvam M

Southeast Asian J. Trop. Med. Public Health, 1974 Sep;5(3):456-7.

PMID: 4215149

Matched MeSH terms: Spleen/parasitology

Mild encephalitis/encephalopathy with reversible splenial lesion (MERS) due to dengue virus

Fong CY, Khine MM, Peter AB, Lim WK, Rozalli FI, Rahmat K

J Clin Neurosci, 2017 Feb;36:73-75.

PMID: 27887978 DOI: 10.1016/j.jocn.2016.10.050

A 14-year-old girl presented with encephalopathy, delirium and ophthalmoplegia following a 3day history of high-grade fever. Brain MRI on day 6 of illness showed diffusion restricted ovoid lesion in the splenium of corpus callosum. Dengue virus encephalitis was diagnosed with positive PCR for dengue virus type-2 in both serum and cerebrospinal fluid. She made a complete recovery from day 10 of illness. Repeat brain MRI on day 12 of illness showed resolution of the splenial lesion. Serial diffusion tensor imaging (DTI) showed normal fractional anisotropy values on resolution of splenial lesion indicating that MERS was likely due to transient interstitial oedema with preservation of white matter tracts. This is the first reported case of MERS following dengue virus infection. It highlights the usefulness of performing serial DTI in understanding the underlying pathogenesis of MERS. Our case report widens the neurological manifestations associated with dengue infection and reiterates that patients with MERS should be managed supportively as the splenial white matter tracts are reversibly involved in MERS.

Matched MeSH terms: Spleen/pathology

Fulltext Rheopathologic Consequence of Plasmodium vivax Rosette Formation

Zhang R, Lee WC, Lau YL, Albrecht L, Lopes SC, Costa FT, et al.

PLoS Negl Trop Dis, 2016 08;10(8):e0004912.

PMID: 27509168 DOI: 10.1371/journal.pntd.0004912

Malaria parasites dramatically alter the rheological properties of infected red blood cells. In the case of Plasmodium vivax, the parasite rapidly decreases the shear elastic modulus of the invaded RBC, enabling it to avoid splenic clearance. This study highlights correlation between rosette formation and altered membrane deformability of P. vivax-infected erythrocytes, where the rosette-forming infected erythrocytes are significantly more rigid than their non-rosetting counterparts. The adhesion of normocytes to the PvIRBC is strong (mean binding force of 440pN) resulting in stable rosette formation even under high physiological shear flow stress. Rosetting may contribute to the sequestration of PvIRBC schizonts in the host microvasculature or spleen.

Matched MeSH terms: Spleen/blood supply; Spleen/metabolism; Spleen/parasitology

Effect of sodium fluoride on the murine splenic immune response to Porphyromonas gingivalis in vitro

Sosroseno W

Immunopharmacol Immunotoxicol, 2003 Feb;25(1):123-7.

PMID: 12675204

Spleen cells from saline- and Porphyromonas gingivalis-primed mice were cultured and stimulated with or without P. gingivalis and added with or without various concentration of sodium fluoride (NaF). Cell proliferation, antigen-specific IgG antibodies and both IFN-gamma and IL-10 levels were determined by a colorimetric assay, ELISA and commercial ELISA kits respectively. The results showed that NaF at concentration of 1 x 10(-6) M enhanced but at concentration of 1 x 10(-1) M abolished the immune response to P. gingivalis, suggesting that NaF at low concentration may act as an adjuvant but at high concentration may be toxic to the P. gingivalis-induced murine splenic immune response in vitro.

Matched MeSH terms: Spleen/cytology; Spleen/drug effects*; Spleen/immunology

Fulltext Computed tomography of focal splenic lesions in patients presenting with fever

Joazlina ZY, Wastie ML, Ariffin N

Singapore Med J, 2006 Jan;47(1):37-41.

PMID: 16397719

INTRODUCTION: There is an awareness of the increased incidence of splenic abscess in Southeast Asia giving rise to unexplained fever. This study looks at the role of computed tomography (CT) in evaluating focal splenic lesions in patients presenting with fever.
METHODS: 37 patients presenting with fever of unknown origin underwent CT and this study retrospectively analyses the findings in these patients. 13 patients also had associated abdominal pain. Patients with conditions at high risk for splenic infection include: diabetes mellitus in ten patients, leukaemia in seven patients, human immunodeficiency virus infection in five patients, intravenous drug abuse in six patients, and steroid therapy in two patients. No risk factors could be identified in seven patients.
RESULTS: Splenic abscess was diagnosed in 28 patients. A range of infecting organisms was isolated but the most frequent were Staphylococcus aureus (eight), tuberculosis (four), Streptococcus (four), fungal (four) and melioidosis (four). No infecting organism could be identified in ten cases though in patients with leukaemia with multiple low attenuation areas, the cause was presumed to be fungal. Six patients were diagnosed to have splenic infarcts though differentiation from splenic abscess could be difficult; these patients were treated for an abscess and all had endocarditis. Three patients were subsequently diagnosed with lymphoma. Percutaneous abscess drainage was performed in five patients and splenectomy was carried out in six patients.
CONCLUSION: CT proved to be very useful as it not only revealed the size and extent of any splenic abnormality but it assisted with guidance for percutaneous drainage, determined the site for biopsy, and provided follow-up after treatment.

Matched MeSH terms: Spleen/microbiology; Spleen/pathology; Spleen/radiography*

Rare variations in the Origin, Branching Pattern and Course of the Celiac Trunk: Report of Two Cases

Prasanna LC, Alva R, Sneha GK, Bhat KM

Malays J Med Sci, 2016 Jan;23(1):77-81.

PMID: 27540329

Multiple anomalies in the celiac arterial system presents as rare vascular malformations, depicting deviations of the normal vascular developmental pattern. We found a common left gastro-phrenic trunk and a hepato-spleno-mesenteric trunk arising separately from the abdominal aorta in one cadaver. We also found a common hepatic artery and a gastro-splenic trunk arising individually from the abdominal aorta in another cadaver. Even though many variations in the celiac trunk have been described earlier, the complex variations described here are not mentioned and classified by earlier literature. Knowledge of such variations has significance in the surgical and invasive arterial radiological procedures in the upper abdomen.

Matched MeSH terms: Spleen

Low CF, Mariana NS, Maha A, Chee HY, Fatimah MY

J Fish Dis, 2015 Aug;38(8):761-4.

PMID: 25073481 DOI: 10.1111/jfd.12283

Matched MeSH terms: Spleen/immunology; Spleen/physiopathology*

A case of severe Plasmodium knowlesi in a splenectomized patient

Boo YL, Lim HT, Chin PW, Lim SY, Hoo FK

Parasitol Int, 2016 Feb;65(1):55-57.

PMID: 26454133 DOI: 10.1016/j.parint.2015.10.003

Plasmodium knowlesi, a zoonotic malaria, is now considered the fifth species of Plasmodium causing malaria in humans. With its 24-hour erythrocytic stage of development, it has raised concern regarding its high potential in replicating and leading to severe illness. Spleen is an important site for removal of parasitized red blood cells and generating immunity. We reported a case of knowlesi malaria in a non-immune, splenectomized patient. We observed the delay in parasite clearance, high parasitic counts, and severe illness at presentation. A thorough search through literature revealed several case reports on falciparum and vivax malaria in splenectomized patients. However, literature available for knowlesi malaria in splenectomized patient is limited. Further studies need to be carried out to clarify the role of spleen in host defense against human malaria especially P. knowlesi.

Matched MeSH terms: Spleen/immunology; Spleen/parasitology

Hepatosplenic lesions induced by experimental Schistosoma malayensis in rabbits

Shekhar KC, Pathmanathan R

Southeast Asian J. Trop. Med. Public Health, 1993 Jun;24(2):333-9.

PMID: 8266238

Two groups of three rabbits each were infected with 250 cercariae of the Baling and Koyan strain of Schistosoma malayensis. Changes induced by both strains included periportal hepatocellular necrosis and fibrosis. Vascular changes such as portal phlebitis and thrombophlebitis and varying degrees of pericholangitis were also present. Amyloid deposition was noted. A comparative study of the changes induced in rabbits by S. malayensis, S. mekongi and S. japonicum showed that the hepatic lesions induced by the Baling strain of S. malayensis were similar to that induced by S. japonicum, and were more severe than that induced by S. mekongi or the Koyan strain.

Matched MeSH terms: Spleen/parasitology; Spleen/pathology*

Fulltext Survival and Intra-Nuclear Trafficking of Burkholderia pseudomallei: Strategies of Evasion from Immune Surveillance?

Vadivelu J, Vellasamy KM, Thimma J, Mariappan V, Kang WT, Choh LC, et al.

PLoS Negl Trop Dis, 2017 01;11(1):e0005241.

PMID: 28045926 DOI: 10.1371/journal.pntd.0005241

BACKGROUND: During infection, successful bacterial clearance is achieved via the host immune system acting in conjunction with appropriate antibiotic therapy. However, it still remains a tip of the iceberg as to where persistent pathogens namely, Burkholderia pseudomallei (B. pseudomallei) reside/hide to escape from host immune sensors and antimicrobial pressure.

METHODS: We used transmission electron microscopy (TEM) to investigate post-mortem tissue sections of patients with clinical melioidosis to identify the localisation of a recently identified gut microbiome, B. pseudomallei within host cells. The intranuclear presence of B. pseudomallei was confirmed using transmission electron microscopy (TEM) of experimentally infected guinea pig spleen tissues and Live Z-stack, and ImageJ analysis of fluorescence microscopy analysis of in vitro infection of A549 human lung epithelial cells.

RESULTS: TEM investigations revealed intranuclear localization of B. pseudomallei in cells of infected human lung and guinea pig spleen tissues. We also found that B. pseudomallei induced actin polymerization following infection of A549 human lung epithelial cells. Infected A549 lung epithelial cells using 3D-Laser scanning confocal microscopy (LSCM) and immunofluorescence microscopy confirmed the intranuclear localization of B. pseudomallei.

CONCLUSION: B. pseudomallei was found within the nuclear compartment of host cells. The nucleus may play a role as an occult or transient niche for persistence of intracellular pathogens, potentially leading to recurrrent episodes or recrudescence of infection.

Matched MeSH terms: Spleen/metabolism; Spleen/microbiology

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