The spleen is not silent in the body. Because it does not often suffer from lesions and is small in size, it can be said that it is an organ with a low sense of existence. However, in fact, the spleen is closely related to immunity, and a small number of people will develop spleen tumors!

40-year-old Ms. Wu accidentally discovered a tumor in her spleen during an abdominal ultrasound during her annual routine health check, but she did not have any uncomfortable symptoms. After several ultrasound and CT examinations, it was found that the tumor had not changed. , The size of the spleen is also stable, but the nature of the tumor has been difficult to determine. Under the advice of the doctor, Ms. Wu decided to undergo biopsy, and the diagnosis was a rare cell hemangioma, so she needed the next step of treatment.

The spleen is located in the upper left side of the human abdominal cavity, approximately in the left-right relative position to the liver in the right upper abdomen. The spleen is about the size of a palm and weighs about 80-300 grams. Since the spleen is located on the inner side of the lower border of the ribs, it is not easy to feel the spleen under normal conditions. In addition, the spleen, like the liver, is less nerve-distributed and therefore less painful.

The spleen is an important lymphoid immune organ

Although the spleen is located on the left side of the abdominal cavity, adjacent to digestive organs such as the stomach and pancreas, its main function is not digestion, but an important lymphoid immune organ of the human body.

During the fetal period, the spleen is mainly responsible for hematopoietic function. In adulthood, the spleen is primarily responsible for removing aging red blood cells from the body and is also a reservoir for platelets and granular white blood cells. In addition, the spleen is also a very important lymphoid organ in the human body, which can filter pathogenic bacteria and antigens in the blood, produce antibodies and stimulate cellular immunity, and also shoulder the heavy responsibility of lymphocyte proliferation. In other words, the spleen is closely related to the body’s immunity and resistance.

The symptoms of spleen tumor are not obvious, and it is easier to find if there is an enlarged spleen

Spleen tumors generally have no symptoms, or the symptoms are not obvious and lack specificity. Self-detection is difficult, and it is usually discovered through examination. Some patients are diagnosed with an abnormality in the spleen by accident during an abdominal ultrasound or kidney ultrasound.

Spleen tumors are generally asymptomatic and are usually detected on an abdominal ultrasound.

If there is a spleen tumor and an enlarged spleen, the doctor may feel it during an abdominal examination, and if an abdominal ultrasound examination is added, it can be confirmed; but if the spleen tumor does not have an enlarged spleen, then the general examination cannot detect it, but must pass Imaging tools, such as abdominal ultrasound, MRI or CT, etc., can be found.

Spleen tumor patients with spleen enlargement may experience abdominal distention and abdominal pain on the left side of the abdomen. Some people may experience difficulty in defecation or constipation due to the enlarged spleen compressing the intestines. However, without an enlarged spleen, these symptoms are not apparent.

In addition, the spleen is involved in blood metabolism. Therefore, if there are lesions in the spleen, it may be accompanied by anemia, thrombocytopenia, or some immune cells related to immunity in white blood cells will also be low, and the patient may have a fever.

The spleen has abundant blood flow, and the biopsy carries the risk of internal bleeding

When it is found that there is a tumor in the spleen, in addition to further arranging imaging examinations to understand its nature, if necessary, biopsy should be performed, and some tissues should be taken for pathological examination. However, the spleen is an organ with extremely rich blood flow, and biopsy sections are prone to cause internal bleeding, so this is not often done in clinical practice; therefore, follow-up examinations are usually arranged first to continuously observe the size changes. When there is a change in the size or shape of the tumor, a biopsy may be done.

Spleen tumors can be divided into lymphoid and non-lymphoid

Splenic tumors can be divided into two categories: lymphoid and non-lymphoid. Lymphoid spleen tumors include Hodgkin’s lymphoma and non-Hodgkin’s lymphoma. There are also histiocytic lymphoma, plasma cell-related tumors, etc., which are usually treated by hematologists.

Non-lymphoid spleen tumors include benign hemangioma, malignant hemangioma, cellular hemangioma, lymphangioma, hemangioendothelioma, fibrosarcoma, nerve-related tumors, lipoma, and the like. Although non-lymphoid splenic tumors are relatively diverse, they are extremely rare. This part is usually followed up by an oncologist or surgeon.

In addition, some systemic diseases can also be manifested by spleen tumors, such as granulomatosis and sarcoidosis, which should be diagnosed with CT or MRI.

In addition to the primary tumor, there are also tumors that have metastasized from other organs, most of which are metastases from melanoma (a type of skin cancer) or breast or lung cancer. In clinical treatment of tumors that metastasize to the spleen from other organs, the principle is to treat tumors at the primary site.

If the spleen tumor becomes large, it is recommended to remove it

The treatment of spleen tumors should first distinguish whether they are benign or malignant.

Benign tumors, the most common of which are hemangiomas, should be partially or completely removed according to the size and growth rate of the tumor. The blood flow of the spleen is very rich, so if the spleen hemangioma is relatively large, or has a tendency to continue to grow larger, or grow rapidly, it may cause the spleen to rupture and cause intra-abdominal hemorrhage. In this case, prophylactic surgical removal of the spleen is recommended. .

In the case of malignant tumors, such as angiosarcoma, chemotherapy or radiation therapy should be combined after the removal of the spleen.

Vaccination to prevent infection before spleen removal

The main effect of removing the spleen is that the immunity will be reduced, and it will be more susceptible to some bacterial infections, such as pneumococcus and Haemophilus b. The vaccine against Haemophilus type bacillus produces protection first and then undergoes spleen removal surgery. After the surgery, it is necessary to be vaccinated regularly for life to avoid infection.

Spleen enlargement often caused by liver cirrhosis

Compared with spleen tumors, splenomegaly is more common in clinical practice and is usually found during abdominal ultrasound. In China, the most common cause is liver cirrhosis. Doctors can even judge the liver from the degree of spleen enlargement. How long and how severe the hardening has been.

This is because when liver cirrhosis is more severe, it will cause portal hypertension, and the blood circulation of the spleen usually first passes through the liver, then enters the inferior vena cava and then returns to the heart. The flow of blood is blocked, causing blood to build up, leading to an enlarged spleen.

It is also worth noting that in patients with liver cirrhosis and splenomegaly, the number of platelets in the body will be relatively low. Therefore, if the patient needs to undergo surgery or perform invasive examinations or treatments, the number of platelets must be paid attention to, and blood transfusions are required to supplement if necessary to avoid Bleeding ceaselessly.

To solve the problem of liver cirrhosis combined with splenomegaly, it is still necessary to start with the treatment of liver cirrhosis, so as to have the opportunity to improve the splenomegaly.