Splenic aspiration in clinical and experimental hematology.

SPIRATI(I)NS OF THE SPLEEN isave beens performed ins 140 patiemsts at Kitsgs Coutity Hospital sinsce 1949, eithetas ats aid to diagnosis or in the course of hematologic research. This repot-t. summarizes the finsdinsgs ohtamed by this technic. \Vidalm late ins the 1 Ptls c-entinry, was pn-ohably the first tc) pun(-ture the spleens for diagnosis. He obtained I)lood fot (utltltn(’ from the spleens-ann accessible part of the reticitloensdothelial system-as a means of diagnsosing typhoid fes’en. Later spleisitaspirations st-as widely used around the Medlitel-n-anseans basins ansd ins Asia iti the diiagnosis of leishmansiasis, trypanosomiasis, ansd malaria.. Little metition is ma(le of mc)rI)iditv and mc)ntality, but the further dcvelopmcnit of the procedure svas attribitted to the reditctions of morbidity by Xagy,1 st-ho ins 1924 emphasized the importaisce of penfonminsg the puncture sthile the patienst was maintaimsitsg deep i nspiratiots. The extensive monographs of Weil2 atsd Moeschlins3 gave impetus to tise most recent svase of inssestigation of splenic aspirationss. No attempt st-ill he made here to give a (-omplete survey of the literatitre sinsce Moeschlins’s extensis-e bibliography (467 referensces) may 1)e t-onssulted by the interested reader. His atsalysis of 300 aspirationss its a n-ide sat-iety of (-ons(litions is supplemenstedi 1w mansy excellent photomicrographs. Block ansci ,Ja(-o1)sons4 st-crc the first insscstigatons ins this country to emphasize the value of material obtainedi from the spleens ins cliagniosis anid also ins evaluatinig the effects of t-hemothem’apy ins hematologic clisondens. They reported ois 92 splensic “puisctures”, 1)itt itsed the Vim-Silvermans nseedle to ol)tains biopsy specimcnss for histologitstudies. Unsfortunsately, ins three of their pat.ienst.s this procedlitre svas follossedl } r instra-abdomintal hemonnlsage teqinirinig transfusions anal its onie patienst. by extenssive hemorrhage unto the nca( tIn5 muscle resultinig ins death. B iopsy spet-imenss gis-e insfonmat iou t-onst-erns inig ar(-hitcct imte, whereas aspirated spe(-imenss give 1:ettcn detail (-onst-ernsiisg (-ytology ; hence a (-oml)insations of tise tsV() st-c)uldi he the ideal. Amyloidosis anscl Boet-k’s sarcoicl5 are examples of clisease ins st-hich the architectitne ssiscl therefore I)iopsy svottld be prefen-red for estahlishinsg a dcfinsitivc diagnosis. \Vac-hsteins6 has n-epom-tec! a case of priman-v hemansgiosarcoma of the spleens cliagnioseci by this method. Hosves-er, sins(-e a nseedle svith a relatively large bore is requinecl fonbiopsy, the hazard of hemorrhage is increased. Most. ins-estigators have tiserefore tonfinsed themselves to the aspirations technic using a small gauge needle. Fortutsat.ely, there are many diseases in svhk-h cell morphology withoint arc-hitecture is sufficienit for a diagnosis. Several large series have beets reported by