Accessory spleen, Hypersplenism, and Splenosis

Q: What is the difference between Accessory spleen, Hypersplenism, and Splenosis?

Answer: A few related terms are commonly used and easy to understand, such as Asplenia (anatomical or physiological absence of the spleen), Hyposplenia (decreased splenic function), and Splenomegaly (large spleen size).

Accessory spleen is the presence of a separate region of splenic tissue in the abdomen. It is not well known that 15 percent of humans carry them.

Hypersplenism refers to splenic sequestration and/or destruction of blood cells (all three lineages) up to causing one or more cytopenias.

Splenosis is mostly iatrogenic by the seeding of the abdominal cavity with splenic cells that can occur during surgery or trauma.

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References:

1. Suttie AW. Histopathology of the spleen. Toxicol Pathol. 2006;34(5):466-503. doi: 10.1080/01926230600867750. PMID: 17067940.

2. Vikse J, Sanna B, Henry BM, Taterra D, Sanna S, Pękala PA, Walocha JA, Tomaszewski KA. The prevalence and morphometry of an accessory spleen: A meta-analysis and systematic review of 22,487 patients. Int J Surg. 2017 Sep;45:18-28. doi: 10.1016/j.ijsu.2017.07.045. Epub 2017 Jul 15. PMID: 28716661.

3. Tandon YK, Coppa CP, Purysko AS. Splenosis: a great mimicker of neoplastic disease. Abdom Radiol (NY). 2018 Nov;43(11):3054-3059. doi: 10.1007/s00261-018-1601-5. PMID: 29651643.