The spleen and lymph nodes

The spleen has important haematological and immunological functions. The spleen is involved in antibody production and cell-mediated responses. It is important for phagocytosis and the maturation of lymphoid cells, and it is significant in lymphopoiesis. Hypersplenism is splenomegaly plus decreased numbers of circulating blood elements. The main purpose of the assessment is to determine whether the spleen is enlarged because of a primary disorder or because it is involved in a generalised disease process. Early complications include bleeding and left subphrenic collection. Immediately following splenectomy, thrombocytosis is common, with an increased risk of thrombotic events. Late complications include migrating thrombophlebitis or deep-venous thrombosis (DVT) caused by thrombocytosis. Palpable lymph nodes should be considered diseased until proven otherwise. Staging depends on results of node biopsy, bone marrow biopsy, and cross-sectional imaging. Peritoneal mesothelioma presents with anorexia, ascites and intestinal obstruction. There is fever and weight loss.