Aggiornamento
La splenomegalia
SPLENOMEGALY IN INFANTS AND CHILDREN
MARCO RABUSIN1, FEDERICA PATARINO2
1UO di Emato-Oncologia Pediatrica;
2Clinica Pediatrica, IRCCS “Burlo Garofolo”, Trieste
Ottobre 2007 - pagg. 493 -499
Abstract
The spleen in infants and children is involved in a wide variety of pathological conditions.
Splenic disorders may be isolated like splenic cysts or, more frequently, due to multiorgan or systemic disease including hepatic diseases, malignancy, hemoglobinopathy, infectious diseases and storage diseases. The Authors review the role of the laboratory test, the ultrasonography and the peripheral blood smear in orienting the differential diagnosis. Invasive procedure as bone marrow aspiration, lymph node biopsy, hepatic biopsy or fine needle splenic biopsy are often warranted to estabilish the cause of splenomegaly.
Parole chiave
Classificazione MeSH
Bibliografia
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2. O’Reilly RA. Splenomegaly in 2505 patients at a large university medical center from 1963 to 1995: 449 patients. West J Med 1998;169:88- 97.
3. Schloesser LL. The diagnostic significance of splenomegaly. Am J Med Sci 1963;245:84- 90.
4. O’Reilly RA. Splenomegaly in 2505 patients at a large university medical center form 1913 to 1962: 2056 patients. West J Med 1998; 169:78-87.
5. Nemcek AA Jr, Miller FH, Fitzgerald SW. Acute torsion of a wandering spleen: diagnosis by CT and duplex Doppler and color flow sonography. AJR Am J Roentgenol 1991;157(2): 307-9.
6. Rosenberg HK, Markowitz R, Kolberg H, Park C, Hubbard A, Bellah RD. Normal splenic size in infants and children: sonographic measurements. AJR Am J Roentgenol 1991; 157:119-21.
7. Donnelly LF, Foss JN, Frush DP, Bisset GS. Heterogenous splenic enhancement patterns of spiral CT images in children: minimizing misinterpretation. Radiology 1999;210:493-7.
8. Ito K Mitchell DG, Honjo K, et al. MR imaging of acquired abnormality of the spleen. AJR Am J Roentgenol 1997;168:697-702.
9. Markisz JA, Treves ST, Davis RT. Normal hepatic and splenic size in children: scintigraphic determination. Pediatr Radiol 1987; 17(4):273-6.
10. Caraway NP, Fanning CV. Use of fine-needle aspiration biopsy in the evaluation of splenic lesion in a cancer center. Diagn Cytopathol 1997;16(4):312-6.
11. Zeppa P, Picardi M, Marino G, et al. Fineneedle aspiration biopsy and flow cytometry immunophenotyping of lymphoid and myeloproliferative disorders of spleen. Cancer 2003; 99(2):118-27.
12. Kelly D. Complications and management of chronic liver disease. In Disease of the liver and biliary system in children. Blackwell Science 1999;11:189-210.
13. Lassau N, Auperin A, Leclere J, Bennaceur A, Valteau-Couanet D, Hartmann O. Prognostic value of doppler-ultrasonography in hepatic veno-occlusive disease. Transplantation 2002;74(1):60-6.
14. Singh V, Sinha SK, Nain CK, et al. Budd- Chiari syndrome: our experience of 71 patients. J Gastroenterol Hepatol 2000;15(5):550- 4.
15. Margolin J. Clinical presentation of Acute Lymphoblastic Leukemia. In: Pizzo, Principles and Practice of Pediatric Oncology, 4th edition 2002; chapter 19, pp 488-527.
16. Barnard DR, Lange B, Alonzo TA, Buckley J, Kobrinsky JN. Acute mieloyd leukemia and myelodisplastic syndrome in children treated for cancer: comparison with primary presentation. Blood 2002;100(2):427-34.
17. Millot F, Traore P, Guilhot J, Nelken B, Leblanc T. Clinical and biological features at diagnosis in 40 children with chronic myeloid leukemia. Pediatrics 2005;116(1):140-3.
18. Magrath I. Malignant NH lymphomas in children, clinical presentation. In: Pizzo, Priciples and Practice of Pediatric Oncology, 4th edition 2002; chapter 24, pp 660-99.
19. Arya LS, Dinand V, Bakhshi S, Thavaraj V, Singh R, Dawar R. Significance of splenomegaly in childhood Hodgkin disease. J Pediatr Hematol Oncol 2004;26(12):807-12.
20. Henter J. Elinder G, Ost A. Diagnostic guidelines for HLH. Seminar Oncol 1991;18:29- 33.
21. Aricò M, Egeler RM. Clinical aspect of Langerhans cell histiocytosis. Hematol Oncol Clin North Am 1998;12(2):247-58.
22. Bolton-Maggs PH. Hereditary spherocytosis; new guidelines. Arch Dis Child 2004; 89(9):809-12.
23. Bunn HF. Pathogenesis and treatment of sickle cell disease. N Engl J Med 1997;337 (11):762-9.
24. Heimpel H, Anselstetter V, Chrobak L, et al.. Congenital dyseritropoietic anemia type II: epidemiology, clinical appearance, and prognosis based on long-term observation. Blood 2003;102(13):4576-81.
25. Cervantes F. Modern management of myelofibrosis. BJH 2004;128:583-92.
26. Salazar A, Mana J, Corbella X, Albareda JM, Pujol R. Splenomegaly in sarcoidosis. Sarcoidosis 1995;12(2):131-4.
27. Kaplan P, Anderson HC, Kacena KA, Yee JD. The clinical and demographic charasteristic of nonneuropathic Gaucher disease in 887 children at diagnosis. Arch Pediatr Adolesc Med 2006;160(6):603-8.
28. Wasserstein MP, Desnick RJ, Schuchman EH, et al. The natural history of type B Niemann- Pick disease: results from a 10 year longitudinal study. Pediatrics 2004;114(6):672-7.
29. Lachaux A, Sassolas A, Bouvier R, et al. Early manifestation of Tangier disease. Arch Pediatr 1995;2(5):447-51.
30. Musy PA, Roche B, Belli D, Bugmann P, Nussle D, le Coultre C. Splenic cyst in pediatric patients: a report of 8 cases and review of the literature. Eur J Pediatr Surg 1992;2(3): 137-40.
31. Abbott R, Levy A, Aguilera NS, Gorospe L, Thompson WM. From the archives of the AFIP: primary vascular neoplasms of the spleen: radiologic-pathologic correlation. Radiographics 2004;24(4):1137-63.
32. Hayes TC, Britton HA, Mewborne EB, Troyer DA, Saldivar VA, Ratner IA. Symptomatic splenic hamartoma:case report and literature review. Pediatrics 1998;101(5):E10.
2. O’Reilly RA. Splenomegaly in 2505 patients at a large university medical center from 1963 to 1995: 449 patients. West J Med 1998;169:88- 97.
3. Schloesser LL. The diagnostic significance of splenomegaly. Am J Med Sci 1963;245:84- 90.
4. O’Reilly RA. Splenomegaly in 2505 patients at a large university medical center form 1913 to 1962: 2056 patients. West J Med 1998; 169:78-87.
5. Nemcek AA Jr, Miller FH, Fitzgerald SW. Acute torsion of a wandering spleen: diagnosis by CT and duplex Doppler and color flow sonography. AJR Am J Roentgenol 1991;157(2): 307-9.
6. Rosenberg HK, Markowitz R, Kolberg H, Park C, Hubbard A, Bellah RD. Normal splenic size in infants and children: sonographic measurements. AJR Am J Roentgenol 1991; 157:119-21.
7. Donnelly LF, Foss JN, Frush DP, Bisset GS. Heterogenous splenic enhancement patterns of spiral CT images in children: minimizing misinterpretation. Radiology 1999;210:493-7.
8. Ito K Mitchell DG, Honjo K, et al. MR imaging of acquired abnormality of the spleen. AJR Am J Roentgenol 1997;168:697-702.
9. Markisz JA, Treves ST, Davis RT. Normal hepatic and splenic size in children: scintigraphic determination. Pediatr Radiol 1987; 17(4):273-6.
10. Caraway NP, Fanning CV. Use of fine-needle aspiration biopsy in the evaluation of splenic lesion in a cancer center. Diagn Cytopathol 1997;16(4):312-6.
11. Zeppa P, Picardi M, Marino G, et al. Fineneedle aspiration biopsy and flow cytometry immunophenotyping of lymphoid and myeloproliferative disorders of spleen. Cancer 2003; 99(2):118-27.
12. Kelly D. Complications and management of chronic liver disease. In Disease of the liver and biliary system in children. Blackwell Science 1999;11:189-210.
13. Lassau N, Auperin A, Leclere J, Bennaceur A, Valteau-Couanet D, Hartmann O. Prognostic value of doppler-ultrasonography in hepatic veno-occlusive disease. Transplantation 2002;74(1):60-6.
14. Singh V, Sinha SK, Nain CK, et al. Budd- Chiari syndrome: our experience of 71 patients. J Gastroenterol Hepatol 2000;15(5):550- 4.
15. Margolin J. Clinical presentation of Acute Lymphoblastic Leukemia. In: Pizzo, Principles and Practice of Pediatric Oncology, 4th edition 2002; chapter 19, pp 488-527.
16. Barnard DR, Lange B, Alonzo TA, Buckley J, Kobrinsky JN. Acute mieloyd leukemia and myelodisplastic syndrome in children treated for cancer: comparison with primary presentation. Blood 2002;100(2):427-34.
17. Millot F, Traore P, Guilhot J, Nelken B, Leblanc T. Clinical and biological features at diagnosis in 40 children with chronic myeloid leukemia. Pediatrics 2005;116(1):140-3.
18. Magrath I. Malignant NH lymphomas in children, clinical presentation. In: Pizzo, Priciples and Practice of Pediatric Oncology, 4th edition 2002; chapter 24, pp 660-99.
19. Arya LS, Dinand V, Bakhshi S, Thavaraj V, Singh R, Dawar R. Significance of splenomegaly in childhood Hodgkin disease. J Pediatr Hematol Oncol 2004;26(12):807-12.
20. Henter J. Elinder G, Ost A. Diagnostic guidelines for HLH. Seminar Oncol 1991;18:29- 33.
21. Aricò M, Egeler RM. Clinical aspect of Langerhans cell histiocytosis. Hematol Oncol Clin North Am 1998;12(2):247-58.
22. Bolton-Maggs PH. Hereditary spherocytosis; new guidelines. Arch Dis Child 2004; 89(9):809-12.
23. Bunn HF. Pathogenesis and treatment of sickle cell disease. N Engl J Med 1997;337 (11):762-9.
24. Heimpel H, Anselstetter V, Chrobak L, et al.. Congenital dyseritropoietic anemia type II: epidemiology, clinical appearance, and prognosis based on long-term observation. Blood 2003;102(13):4576-81.
25. Cervantes F. Modern management of myelofibrosis. BJH 2004;128:583-92.
26. Salazar A, Mana J, Corbella X, Albareda JM, Pujol R. Splenomegaly in sarcoidosis. Sarcoidosis 1995;12(2):131-4.
27. Kaplan P, Anderson HC, Kacena KA, Yee JD. The clinical and demographic charasteristic of nonneuropathic Gaucher disease in 887 children at diagnosis. Arch Pediatr Adolesc Med 2006;160(6):603-8.
28. Wasserstein MP, Desnick RJ, Schuchman EH, et al. The natural history of type B Niemann- Pick disease: results from a 10 year longitudinal study. Pediatrics 2004;114(6):672-7.
29. Lachaux A, Sassolas A, Bouvier R, et al. Early manifestation of Tangier disease. Arch Pediatr 1995;2(5):447-51.
30. Musy PA, Roche B, Belli D, Bugmann P, Nussle D, le Coultre C. Splenic cyst in pediatric patients: a report of 8 cases and review of the literature. Eur J Pediatr Surg 1992;2(3): 137-40.
31. Abbott R, Levy A, Aguilera NS, Gorospe L, Thompson WM. From the archives of the AFIP: primary vascular neoplasms of the spleen: radiologic-pathologic correlation. Radiographics 2004;24(4):1137-63.
32. Hayes TC, Britton HA, Mewborne EB, Troyer DA, Saldivar VA, Ratner IA. Symptomatic splenic hamartoma:case report and literature review. Pediatrics 1998;101(5):E10.
Corrispondenza: rabusin@burlo.trieste.it