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Anatomy · Histology: spleen
Sample itemA 24-year-old man has a blood film two weeks after splenectomy for trauma. It shows red cells with single round basophilic nuclear remnants (Howell-Jolly bodies). Which splenic compartment normally removes these inclusions?
Original practice item, not a recalled exam question. Nothing here is recorded.
The answer and the reasoning
A. Red pulp, through macrophages of the splenic cords and sinuses
The red pulp consists of splenic cords and venous sinusoids lined by macrophages. Red cells must squeeze through slits in the sinus wall, and macrophages pit out nuclear remnants and remove aged cells. After splenectomy this filtering is lost, so Howell-Jolly bodies appear and the patient also needs vaccination against encapsulated organisms.
Option by option
A. Red pulp, through macrophages of the splenic cords and sinuses (correct)
Correct. The red pulp macrophages pit out inclusions and cull old red cells.
B. Splenic trabeculae and capsule
Trabeculae and capsule are connective tissue support and are not the site where red cell inclusions are removed.
C. Periarteriolar lymphoid sheath of the white pulp
The periarteriolar lymphoid sheath is a T-cell zone and does not filter red cells.
D. Marginal zone follicles of the white pulp
The marginal zone is part of the white pulp and handles blood-borne antigens, not red cell inclusions.
Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.
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