Splenic Cystic Lesions – Differential Diagnosis

Congress:

ECR 2013

Poster Number:

C-1343

Type:

Educational Exhibit

Keywords:

Abdomen, Spleen, CT, Ultrasound, Diagnostic procedure, Cysts, Neoplasia, Abscess

Authors:

N. Neto¹, P. G. M. G. Ferreira², A. Vasconcelos³; ¹Lisbon/PT, ²Amadora/PT, ³Barreiro/PT

DOI:

10.1594/ecr2013/C-1343

DOI-Link:

https://dx.doi.org/10.1594/ecr2013/C-1343

Fig. 1: US scan of a patient, who presented with left upper quadrant pain, revealed a...

Fig. 2: Unenhanced CT scan of the same patient as in figure 1, confirmed the...

Fig. 3: Contrast-enhanced CT scan of a patient, who had had an acute pancreatitis...

Fig. 4: Another “false” cyst detected in a patient who had had a blunt abdominal...

Learning objectives

To review the spectrum of cystic lesions of the spleen, with the corresponding epidemiology, pathology and imaging features. To illustrate their characteristic imaging features regarding the differential diagnosis, when possible.

Background

Cystic lesions of the spleen are rare, occurring less often than in other abdominal viscera [1]. Most are benign and found incidentally at radiologic examination. Occasionally, they may become symptomatic, causing a left upper quadrant painful mass, by the extrinsic mass effect on adjacent organs or, less commonly, by developing complication features of hemorrhage, rupture, or superimposed infection, these usually coursing with fever and inflammatory laboratory parameters, being effectively treated by splenectomy [2, 3] or by percutaneous fine-needle aspiration and drainage in selected cases [4]....

Imaging findings OR Procedure details

From our institution’s database, we have selected the most characteristic cases of splenic cystic lesions, some of them confirmed by pathological examination. For each kind of lesion, imaging features are presented and correlated with the findings reported in the available literature, which are resumed in table 1 at the end of this section, regarding their number, the appearance of their wall and the presence or absence of septa and peripheral calcifications. “SPLENIC CYSTS” Both epidermoid and pseudocysts are usually simple spherical cystic lesions in imaging,...

Conclusion

Although differential diagnosis of splenic cystic lesions by imaging is difficult, because of the overlap of their radiologic findings, it can be somewhat narrowed by evaluating the imaging characteristics. Furthermore, their prompt and accurate diagnosis is helpful in surgical planning and in prevention of further expansion with potential complications.

References

Davis CE Jr, Montero JM, VanHorn CN. Large Splenic Cysts. Ann Surg 1994, 173: 686-692. Faer MJ, Lynch RD, Lichtenstein JE, Madewell JE, Felgin DS. RCP from the AFIP. Diagnostic Radiology, 134: 371-376. Freeman JL, Jafri ZH, Roberts JL, Mezwa DG, Shirkhoda A. CT of Congenital and Acquired Abnormalities of the Spleen. RadioGraphics 1993, 13: 597-610. Tikkakoski T, Siniluoto T, Paivansalo M et al. Splenic Abscess: Imaging and Intervention. Acta Radiol 1992, 33: 561-565. Rabushka LS, Kawashima A, Fishman EK. Imaging of the Spleen: CT...