Abstract
Benign focal lesions of the spleen can be categorized into benign tumor, cystic lesion, and infectious lesion. The most common benign tumor of the spleen is hemangioma, followed by hamartoma and lymphangioma. They often present as single lesions, but infrequently multiple lesions such as hemangiomatosis or lymphangiomatosis can be detected. They are usually found incidentally during imaging evaluation for various reasons because they usually do not make symptoms or clinically relevant signs. However, they infrequently cause symptoms by compressing adjacent organs, due to associated changes of splenic function such as anemia or thrombocytopenia, and also they rarely need emergent interventional or surgical intervention due to hemorrhage or rupture. Littoral cell angioma and sclerosing angiomatoid nodular transformation are recently defined benign spleen-specific disease entities. Although they can be presented with typical imaging findings, it is not easy to correctly diagnose because of its low incidence. Pseudocyst consists of approximately 90 % of non-parasite-related splenic cystic lesions. Epidermoid cyst which is a true cyst of congenital origin accounts for the rest of nonparasitic splenic cystic lesions. Echinococcal cyst may present with typical imaging findings, but it is rare outside the endemic area of echinococcus infection. Infectious disease can be accompanied with clinical symptoms such as fever, and medical history of the patient may be helpful for differentiating them from tumorous lesions.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Suggested Reading
Akhan O, Koroglu M. Hydatid disease of the spleen. Semin Ultrasound CT MR. 2007;28(1):28–34.
Lee H, Maeda K. Hamartoma of the spleen. Arch Pathol Lab Med. 2009;133(1):147–51.
Warshauer DM, Hall HL. Solitary splenic lesions. Semin Ultrasound CT MR. 2006;27(5):370–88.
Ros PR, Moser Jr RP, Dachman AH, Murari PJ, Olmsted WW. Hemangioma of the spleen: radiologic pathologic correlation in ten cases. Radiology. 1987;162(1 Pt 1):73–7.
Falk S, Stutte HJ, Frizzera G. Littoral cell angioma. A novel splenic vascular lesion demonstrating histiocytic differentiation. Am J Surg Pathol. 1991;15(11):1023–33.
Safran D, Welch J, Rezuke W. Inflammatory pseudotumors of the spleen. Arch Surg. 1991;126(7):904–8.
Shirkhoda A, Freeman J, Armin AR, Cacciarelli AA, Morden R. Imaging features of splenic epidermoid cyst with pathologic correlation. Abdom Imaging. 1995;20(5):449–51.
Ferrozzi F, Bova D, Draghi F, Garlaschi G. CT findings in primary vascular tumors of the spleen. AJR Am J Roentgenol. 1996;166(5):1097–101.
Irie H, Honda H, Kaneko K, Kuroiwa T, Fukuya T, Yoshimitsu K, Aibe H, Hirakata R, Horie Y, Maeda T, et al. Inflammatory pseudotumors of the spleen: CT and MRI findings. J Comput Assist Tomogr. 1996;20(2):244–8.
Ramani M, Reinhold C, Semelka RC, Siegelman ES, Liang L, Ascher SM, Brown JJ, Eisen RN, Bret PM. Splenic hemangiomas and hamartomas: MR imaging characteristics of 28 lesions. Radiology. 1997;202(1):166–72.
Tsitouridis J, Stamos S, Hassapopoulou E, Tsitouridis K, Nikolopoulos P. Extramedullary paraspinal hematopoiesis in thalassemia: CT and MRI evaluation. Eur J Radiol. 1999;30(1):33–8.
Polat P, Kantarci M, Alper F, Suma S, Koruyucu MB, Okur A. Hydatid disease from head to toe. Radiographics. 2003;23(2):475–94; quiz 536–477.
Solomou EG, Patriarheas GV, Mpadra FA, Karamouzis MV, Dimopoulos I. Asymptomatic adult cystic lymphangioma of the spleen: case report and review of the literature. Magn Reson Imaging. 2003;21(1):81–4.
Takayama A, Nakashima O, Kobayashi K, Kojiro M. Splenic lymphangioma with papillary endothelial proliferation: a case report and review of the literature. Pathol Int. 2003;53(7):483–8.
Abbott RM, Levy AD, Aguilera NS, Gorospe L, Thompson WM. From the archives of the AFIP: primary vascular neoplasms of the spleen: radiologic-pathologic correlation. Radiographics. 2004;24(4):1137–63.
Levy AD, Abbott RM, Abbondanzo SL. Littoral cell angioma of the spleen: CT features with clinicopathologic comparison. Radiology. 2004;230(2):485–90.
Martel M, Cheuk W, Lombardi L, Lifschitz-Mercer B, Chan JK, Rosai J. Sclerosing angiomatoid nodular transformation (SANT): report of 25 cases of a distinctive benign splenic lesion. Am J Surg Pathol. 2004;28(10):1268–79.
Kamaya A, Weinstein S, Desser TS. Multiple lesions of the spleen: differential diagnosis of cystic and solid lesions. Semin Ultrasound CT MR. 2006;27(5):389–403.
Chang WC, Liou CH, Kao HW, Hsu CC, Chen CY, Yu CY. Solitary lymphangioma of the spleen: dynamic MR findings with pathological correlation. Br J Radiol. 2007;80(949):e4–e6.
Tatli S, Cizginer S, Wieczorek TJ, Ashley SW, Silverman SG. Solitary littoral cell angioma of the spleen: computed tomography and magnetic resonance imaging features. J Comput Assist Tomogr. 2008;32(5):772–5.
Huynh MQ, Barth P, Sohlbach K, Neubauer A, Gorg C. B-mode ultrasound and contrast-enhanced ultrasound pattern of focal extramedullary hematopoiesis of the spleen in a patient with myeloproliferative disease. Ultraschall Med. 2009;30(3):297–9.
Subhawong TK, Subhawong AP, Kamel I. Sclerosing angiomatoid nodular transformation of the spleen: multimodality imaging findings and pathologic correlate. J Comput Assist Tomogr. 2010;34(2):206–9.
Hudson JB, Murad FM, Kunkel JE, Collins BT. Endoscopic ultrasound guided fine-needle aspiration of a splenic hemangioma with extramedullary hematopoiesis. Diagn Cytopathol. 2011. doi:10.1002/dc.21862.
McInnes MD, Kielar AZ, Macdonald DB. Percutaneous image-guided biopsy of the spleen: systematic review and meta-analysis of the complication rate and diagnostic accuracy. Radiology. 2011;260(3):699–708.
Chen YY, Shyr YM, Wang SE. Epidermoid cyst of the spleen. J Gastrointest Surg. 2012;17(3):555–61.
Kim HJ, Kim KW, Yu ES, Byun JH, Lee SS, Kim JH, Lee JS. Sclerosing angiomatoid nodular transformation of the spleen: clinical and radiologic characteristics. Acta Radiol. 2012;53(7):701–6.
Krl EA, Orhan D, Haliloglu M, Karnak I. Invasive inflammatory myofibroblastic tumor of the spleen treated with partial splenectomy in a child. J Pediatr Hematol Oncol. 2012;34(4):e131–e3.
Raman SP, Singhi A, Horton KM, Hruban RH, Fishman EK. Sclerosing angiomatoid nodular transformation of the spleen (SANT): multimodality imaging appearance of five cases with radiology-pathology correlation. Abdom Imaging. 2013;38(4): 827–34.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2014 Springer-Verlag Berlin Heidelberg
About this chapter
Cite this chapter
Chung, Y.E. (2014). Benign Focal Lesions of the Spleen. In: Choi, B. (eds) Radiology Illustrated: Hepatobiliary and Pancreatic Radiology. Radiology Illustrated. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-35825-8_24
Download citation
DOI: https://doi.org/10.1007/978-3-642-35825-8_24
Published:
Publisher Name: Springer, Berlin, Heidelberg
Print ISBN: 978-3-642-35824-1
Online ISBN: 978-3-642-35825-8
eBook Packages: MedicineMedicine (R0)