Capsules

THE BORN-AGAIN SPLEEN

Though surprisingly little is known about the spleen, a small organ located beneath the left rib cage, it has at least one important function: filtering bacteria and foreign material from the blood. That function makes the spleen particularly important in warding off serious bacterial infections and meningitis in children, who have not yet developed immunity to certain microorganisms. Yet doctors have long been puzzled by the fact that such infections, relatively common in children whose spleens have been removed in the treatment of cancer or blood disease, seldom show up in youngsters whose spleens have ruptured and then been removed. Now a team of Yale University researchers thinks it has part of the answer.

The Yale team, headed by Pediatrician Howard Pearson, examined 22 patients who had had damaged spleens removed after childhood accidents. Blood tests showed that in 13 of the patients, spleen-like filtering of the blood was apparently continuing, even though their spleens had been removed from one to eight years before the examination. Subsequent radioactive scanning of the abdomens of five of the 13 revealed small nodules of spleen tissue. What had happened, the doctors conclude in the New England Journal of Medicine, was that cells from the ruptured organ spilled out, became implanted in the walls of the abdominal cavity and grew into clusters of cells that were acting as "mini-spleens." The Yale team's nontechnical name for the phenomenon: the born-again spleen.

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