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The Korean Journal of Pathology 1972;6(2): 115-122.
만성울혈성 비종의 병리학적 검색
Histopathological study on chronic congestive splenomegaly
ABSTRACT
The spleen consisted of mesenchymal tissue mainly with splenic cord is specific organ on the circulatory point of view that communicating to the portal system and bearing quite characteristic structure different from ordinary capillaries playing a role as terminal route of end circulation where arteriovenovs shunt exists. And changes in splenic cord is sensitively occur under variable conditions. It is quite natural that circulatory disturbance in portal system giving rise considerable influence to the splenic histologic architecture. A number of previous reports for normal anatomical and structural studies on splenic cord (1, 3, 4, 5) are rather limited to cellular component in splenic cord and not extended to the changes of lattice fiber in process of demolishing or reconstructing pattern in congestive splenopathy. Koboth’s study on splenic cord by reconstruction of tissue sections revealed regular arrangement of lattice fiber that contributed to basic ideal pattern to be investigated to understand pathological changes in chronic congestive splenopathy (splenomegaly). Material and
Method:
Among 98 autopsy cases (male-72, female-26) associated with underlying cause of hepatic diseases, examined at the National Medical Center during the period of last 10 years from 1958 to 1968, 50 cases (male-39, female-11) of chronic congestive splenomegaly were selected and classified by sex, age and in disease group. Also statistical study on correlation between liver and spleen in weight was made. For histopathologic findings ordinary paraffin section of Hematoxylin Eosin(H-E) staining, Masson’s Trichrom(collagen), Weigret Elastic Van Gieson (Elastic fiber), and Grocott Methenamine-Silver (Lattice fiber) staining were performed to observe the changes of lattice fiber in splenic cord during the course of hepatic diseases with splenomegaly. Result: 1. Age on motality showed no significant difference in sex. Age distribution in disease group reveal hepatic abscess 5-29y, hepatoma 35-55y, cirrhosis 9-59y, and average 24.5, 34.2 and 44.5 year respectively. 2. No remarkable sex difference is noted in frequency of hepatic abscess. But cirrhosis group showed ratio of 25 : 8 (male: female) and hepatoma group 13 : 1 with dominant incidence in male. 3. In cirrhotic group average of liver and spleen with standard deviation are as follows 933.34±268.74g., 470.83g±225.42g. and reveals moderate atrophy or shrinkage of liver and splenomegaly. Correlation coefficient between liver and spleen is r= -0.25 indicating slight reverse correlation. Regression line quotent spleen(χ) to liver(y) and liver to spleen is χ= 668.23-0, 12y, and y= 1074.87-0.30χ respectively. 4. In hepatoma group average weight of liver and spleen with standard deviation are as follows 2354.56g±688.04g, 265.91g±87.43g. and reveal pronounced hepatomegaly associated with mild splenomegaly. Correlation coefficient between liver and spleen is r= -0.41 presenting slight reverse correlation. Regression line quotent spleen to liver and liver to spleen is χ= 658.23-0.21y, and y=1074.87-0.30y respectively. 5. Hematoxylin-Eosin stain revealed no definite structural alteration except sinusoidal distension, endothelial proliferation, widening of splenic cord and periarterial fibrosis in Malpighian corpuscles. 6. Alteration of lattice fiber is quite characteristic with dissociation of GF (Grenzfaser), fine network formation, nextly forming small sinuses dividing in to splenic cord, from which histologic architectural changing process in splenomegaly due to portal hypertension is partly explainable. 7. Senile spleen with ordinary hematoxylin-Eosin (H-E) stain showed no much difference from mild degree of splenomegaly. However, silver staining for lattice fiber reveals further complicating findings than splenomegaly with atrophy or destruction of cord bearing fragmentation of R.F. and demolishing of Mgm, and Mmf. No evidence of newly forming sinuses is noted. 8. Special staining employed for collagen and elastic fiber had not given much contribution on the histological study of splenomegaly.
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