SPLENIC REGENERATION AFTER PARTIAL SPLENECTOMY FOR GAUCHER-DISEASE - HISTOLOGICAL FEATURES

Partial splenectomy for Gaucher disease is often followed by reenlarge ment of the splenic remnant. It remains unclear if this process is due to tissue regeneration or to continued deposition of glucocerebroside in the reticuloendothelial system or both. We compared the splenic ar chitecture before and after reenlargement in three cases of failed rep eated partial splenectomy after two, six and five, years. Using the nu mber of lymphoid follicles per hundred low power fields (LF/LPF) as an arbitrary index, we found that prior to the first operation 18, 20 an d 27 lymphoid follicles were present per one hundred low power fields, while at the second operation, the corresponding rates were 11, 15 an d 17; in control spleens, an average of 712.5 lymphoid follicles were present in one hundred low power fields. The difference in the LF/LPF ratio before and after reenlargement, led us to speculate that splenic re-enlargement in Gaucher disease is mainly the result of the continu ed deposition of the glucocerebroside in the reticuloendothelial syste m of the splenic remnant, though some degree of true regeneration as w ell cannot be completely ruled out. These findings are compared with a nimal studies and results for partial splenectomy on humans, performed for trauma. Further studies in patients with Gaucher disease are warr anted to better define the underlying mechanism of splenic reenlargeme nt. (C) 1998 Academic Press.