Spleen ITP - EChin

Spleen ITP - EChin - ITP and Splenic Lymphoma Edward Chin,...

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ITP and Splenic Lymphoma Edward Chin, MD March 19, 2004
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U/S 2/25/04
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CT 2/27/04
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Liver-spleen Scan 3/1/04
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Operative Findings Exploratory laparoscopy Normal-sized spleen, no obvious mass No accessory spleens Splenectomy performed; 1 pool plt given Extraction via enlarged trocar site JP left
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Postop Course Plt count = 96K several hrs postop Clear liquids on POD#1, advanced Plt = 156 on POD#2 JP d/c’d on POD#3 Awaiting NH placement
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Pathology Spleen = 132 g. Atypical histiocytic infiltrates with hemophagocytosis, consistent with involvement by true histiocytic lymphoma/histiocytic sarcoma
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ITP Acquired disorder, classically affecting young women Insidious vs. acute onset (bleeding) History of antecedent infection in pediatric cases (84%) Cross-reactivity b/w anti-viral Abs and plt antigens?
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Thrombocytopenia 3 mechanisms: decreased marrow production increased splenic sequestration accelerated destruction of plts Normal spleen: 30% of total plts within Splenectomy thrombocytosis (by 30%)
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Manifestations Petechiae/purpura, easy bruising Epistaxis, gingival bleeding, menorrhagia GI bleeding, gross hematuria rare Intracranial hemorrhage even rarer Mucocutaneous bleeding:
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Differential Diagnosis Gestational thrombocytopenia/ecclampsia
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This note was uploaded on 12/27/2011 for the course STEP 1 taught by Professor Dr.aslam during the Fall '11 term at Montgomery College.

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Spleen ITP - EChin - ITP and Splenic Lymphoma Edward Chin,...

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