Surgical Pathology Specimens Clinical Aspects

Splenectomy may be a diagnostic procedure. The common indications for splenectomy are: traumatic rupture, suspected primary lymphoma, symptom control in massive splenomegaly, e.g., CML and correction of cytopenias in hypersplenism.

Contraindication: marrow failure where haemopoiesis in the spleen is a source of circulating blood cells.

Immediately after splenectomy an increase in WCC and platelet counts occur but this normalises in 2 or 3 weeks. In the long term there are erythrocyte abnormalities including anisocytosis, poikilocytosis, Howell-Jolly bodies and Heinz bodies. A major consequence of splenectomy is increased susceptibility to bacterial infections due to S. pneumoniae, H. influenzae and sepsis. This requires pneumococcal vaccination and lifelong antibiotic prophylaxis.

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