Lecture notes for medical students

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2. Introduction & History.

3. Introduction & History.
• Splenic cysts have been seen with
increasing frequency since the advent of CT
and ultrasound scanning.
•

4. Aetiology

5. Aetiology
• Idiopathic
• Congenital/Genetic
• Traumatic
• Infections /Infestation: Hydatid
• Autoimmune
• Neoplastic (Benign/Malignant)
• Degenerative
• Iatrogenic

6. Classification

7. Classification
• True cysts 10-20%
– Parasitic: hydatid disease
– Nonparasitic,
• Pseudocysts. 70-80%
• CysticTumors :
– lymphangiomas
– cavernous hemangiomas .

8. Clinical Features

9. Clinical Features
• Demography
• Symptoms
• Signs
• Prognosis
• Complications

10. Pathology

11. Pathology
• Primary True cysts
– lined with a squamous epithelium
– congenital.
– These epithelial cells are often positive for
carbohydrate antigen 19-9 (CA19-9) and
carcinoembryonic antigen (CEA)
– may have elevated serum levels of one or both
of these tumor markers.
– However, are benign and apparently do not
have malignant potential beyond that of the
surrounding native tissue.

12. Pathology
• Pseudocysts of the spleen are not lined with
epithelium.
• A history of prior trauma can typically be
elicited.

13. Symptoms

14. Symptoms
• Asymptomatic and discovered incidentally.
• Abdominal fullness
• Early satiety
• Pleuritic chest pain
• Shortness of breath
• Left shoulder or back pain.
• Renal symptoms from compression of the
left kidney.

15. Signs

16. Signs
• On physical examination, an abdominal
mass may be palpable.

17. Complications

18. Complications
• Rarely, splenic cysts present with acute
symptoms related to rupture, hemorrhage,
or infection.

19. Investigations

20. Investigations
• Laboratory Studies
– Routine
– Special
• Imaging Studies
• Tissue diagnosis
– Cytology
• FNAC
– Histology

21. Diagnostic Studies

22. Diagnostic Studies
Imaging Studies
• X-Ray
• USG
• CT
• Angiography
• MRI
• Endoscopy
• Nuclear scan

23. Operative Therapy

24. Operative Therapy
• Total or partial splenectomy .
• Cyst wall resection
• Partial decapsulation
• Partial splenectomy has the advantage of
preserving splenic function; 25% of the
spleen is sufficient to protect against
pneumococcal pneumonia.
• Hydatid –Splenectomy /PAIR.
• Small cysts can be observed.

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