Hemangioma of the spleen - Color Ultrasound


Title: Color Ultrasound - Hemangioma of the spleen
Diagnosis: Hemangioma of the spleen
Author: Dr.ROSSET Antoine
Comment: Dr. KHAN Haleem
Hospital: HUG
Department: Radiologie
State: Terminée
Date: 21.03.2003
: 4261
Chapter: Liver & Spleen

Clinical Presentation: Incidental finding of a splenicnodule.
Comment: Focal solid splenic lesions are rare but can be causedby a number of
pathologies. The most common are a result ofprevious histoplasmosis or tuberculosis
infection. These lesionsare usually hyperechoic with or without shadowing. Hemangiomas
ofthe spleen have been reported in up to 14% of autopsy studies. Theyare usually an
isolated phenomenon but can be associated withKlippel-Trenaunay-Weber syndrome.
Sonographically, the appearanceof these lesions can be variable. Often they are
hyperechoic butlesions of mixed echogenicity with cystic components can
beencountered. Primary malignant lesions are exceptional but cases ofprimary lymphoma
and angiosarcoma have been reported. Metastaticinvolvement of the spleen is common in
malignant melanoma,lymphoma, and leukemia. Carcinomas of the GU tract, breast,
lungand stomach may also be responsible. Lesions are usually hypoechoicbut can be
hyperechoic or of mixed echogenicity. The differentialdiagnosis includes splenic infarction
which is typicallyperipheral, wedge shaped and triangular. Their appearance varieswith
time and can be indeed hyperechoic when fibrosis is present.Gaucher's disease may
present with hypoechoic lesions andschistosomiasis with hyperechoic lesions. CT and or
MRI findingsare not pathognomonic and diagnosis is usually obtained by
clinicalcorrelation, histology (fine needle) or surgery.
Description: US of the left upper quadrant reveals a solitarypredominantly
hypoechoic solid splenic mass. The lesion displayed asmall central hyperechoic
calcification which was suggestive of aphlebolith. The lesion was not hypervascular on
CDFI. On CT thelesion was hypodense on the unenhanced study and with
contastinjection late films revealed contrast filling. The small focus ofcalcification was not
seen on CT. The diagnosis of hemangioma wasmade on the basis of lesion stability over 2
years and absence ofany coexisting tumoral or metabolic pathology. Moreover, there
wasno known exposure to histoplasmosis nor tuberculosis.

Order: 1021
Dislocation: 0
Polytrauma: 0
Open: 0
Pathologic: 0
Operation: 00.00.00
Graft: 0

Images and Videos

Case Comments:

  • No comments yet