Spectrum of splenic pathology at a single centre

Spleen, a friable and highly vascular organ lying in the left hypochondrium protected by rib cage, was considered by Galen as an organ full of mystery. Observing the patients who were congenitally asplenic, yet leading normal lives, Aristotle came to a conclusion that spleen was not essential for life. Splenectomy, as a surgical procedure is frequently indicated in those cases where the diagnosis is already established and the purpose of surgery being largely therapeutic or palliative in nature. Splenectomy for diagnostic purposes is quite uncommon.

The objective of present study was to study the diagnostic histomorphological features of splenectomies at a single surgical centre in detail.

The present study was undertaken at Department of pathology, Osmania General Hospital, Hyderabad from June 2001 to May 2003. We reviewed 41 specimens that were received over a span of 2 years. All the splenectomy specimens had been formalin fixed, processed, paraffin embedded after meticulous gross examination and sectioned. The Hematoxylin and Eosin stained slides were reviewed by study pathologists.

41 cases of splenectomy were analyzed. There were 18 males and 23 females. Commonest splenic pathology was chronic venous congestion, followed by epidermoid cyst, Hydatid cyst and granulomatous inflammation. Splenic abscess was the least common splenic pathology. No cases of malignancy or metabolic diseases were encountered. Histopathological findings of spleen in various conditions were consistent with the changes consequential to the disease.

Chronic venous congestion of spleen proved to be the commonest indication for splenectomy in our study. Fine needle aspiration cytology and core biopsy play an important role in diagnosis of pathological lesions of many organs, while splenectomy specimen forms the first and only opportunity for diagnosis of splenic pathology.