Analysing the clinical and pathological aspects of splenectomy specimens

Abstract

Objectives : The aim of this study is to find out various causes of splenic pathology in splenectomy specimens and to know their incidence, frequencies with their age and sex incidence and to match the clinical and the pathological diagnosis. Method: All the splenectomy specimens were grossed and processed methodically in detail. Immunohistochemistry and special stains were carried out wherever indicated. Results: Causes of splenectomy ranged from benign causes like traumatic rupture, cyst, hemolytic anaemias, chronic venous congestion (CVC), Immune thrombocytopenic purpura (ITP) and inflammatory lesions like tuberculosis to malignant lesion (splenic marginal zone lymphoma) which was confirmed by Immunohistochemistry (IHC) and cytogenetics. All cases were clinically, thoroughly investigated. Most common pathology was found to be hemolytic anaemias (28%), followed by tuberculosis (18%), ITP (18%), 9% each of splenic cyst, traumatic rupture, chronic venous congestion and splenic marginal zone lymphoma. Conclusion: Most common etiology of splenic pathology leading to splenectomy was hemolytic anaemias followed by tuberculosis and ITP. Splenic cyst, traumatic rupture, chronic venous congestion and splenic marginal zone lymphoma were other rare lesions found in splenectomy specimens. The sex ratio was found to be slightly female predominance. Clinical diagnosis differed from pathological diagnosis in three cases. Pathological diagnosis helped in the post-operative management of the cases.