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Ann Diagn Pathol. 2015 Oct;19(5):288-95. doi: 10.1016/j.anndiagpath.2015.06.004. Epub 2015 Jun 9.

Recommendations for gross examination and sampling of surgical specimens of the spleen.

Author information

1
Clarient Diagnostic Services, 31 Columbia, Aliso Viejo, CA, 92656. Electronic address: domalley@clarientinc.com.
2
Pathology Service, Massachusetts General Hospital, 55 Fruit St, Boston, MA, 02114. Electronic address: alouissaint@partners.org.
3
TriCore Reference Laboratories, 1001 Woodward Place NE, Albuquerque, NM, 87102. Electronic address: mvasef@salud.unm.edu.
4
Joint Pathology Center, 606 Stephen Sitter Ave, Silver Spring, MD, 20910. Electronic address: aaron.auerbach.civ@mail.mil.
5
MD Anderson Cancer Center/University of Texas, Room 4.2115b, Clark Clinic, 1515 Holcombe Blvd, Houston, TX, 77030. Electronic address: Roberto.miranda@mdanderson.org.
6
Department of Pathology, USC Keck School of Medicine, 2011 Zonal Ave HMR 209, Los Angeles, CA, 90033. Electronic address: brynes@usc.edu.
7
Department of Pathology and Laboratory Medicine, University of North Carolina School of Medicine, CB no. 7525, Chapel Hill, NC, 27599. Electronic address: Gfedoriw@unch.unc.edu.
8
Yale Department of Pathology, 310 Cedar St, New Haven, CT, 06520. Electronic address: david.hudnall@yale.edu.

Abstract

This review examines handling and processing of spleen biopsies and splenectomy specimens with the aim of providing the pathologist with guidance in optimizing examination and diagnosis of splenic disorders. It also offers recommendations as to relevant reporting factors in gross examination, which may guide diagnostic workup. The role of splenic needle biopsies is discussed. The International Spleen Consortium is a group dedicated to promoting education and research on the anatomy, physiology, and pathology of the spleen. In keeping with these goals, we have undertaken to provide guidelines for gross examination, sectioning, and sampling of spleen tissue to optimize diagnosis (Burke). The pathology of the spleen may be complicated in routine practice due to a number of factors. Among these are lack of familiarity with lesions, complex histopathology, mimicry within several types of lesions, and overall rarity. To optimize diagnosis, appropriate handling and processing of splenic tissue are crucial. The importance of complete and accurate clinical history cannot be overstated. In many cases, significant clinical history such as previous lymphoproliferative disorders, hematologic disorders, trauma, etc, can provide important information to guide the evaluation of spleen specimens. Clinical information helps plan for appropriate processing of the spleen specimen. The pathologist should encourage surgical colleagues, who typically provide the specimens, to include as much clinical information as possible.

KEYWORDS:

gross examination; histology; pathology; sampling; spleen

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