Learning objectives
We expose the principal imaging characteristics of splenic granulomatosis,
in order to interpret the findings correctly,
reaching whenever possible the appropriate diagnosis.
Background
Pathologic conditions of the spleen can be classified into the following categories: congenital diseases (accessory spleen,
polysplenia,
and asplenia); trauma; inflammation (abscess,
candidiasis,
histoplasmosis,
and sarcoidosis); vascular disorders (infarction,
diseases affecting the splenic vasculature,
and arteriovenous malformation); hematologic disorders (sickle cell disease and extramedullary hematopoiesis); benign tumors (cysts,
hemangioma,
diffuse hemangiomatosis of the spleen,
and hamartoma); malignant tumors (sarcoma,
lymphoma,
and metastases); and other disease processes that affect the spleen diffusely (portal hypertension,
Gaucher disease,
and sickle cell disease) or focally (Gamna-Gandy nodules).
New magnetic...
Findings and procedure details
The radiological aspect of splenic granulomatosis has been defined in literature.
Generally,
US (UltraSonography),
CT (Computed Tomography) and MRI (Magnetic Resonance Imaging) show organomegaly.
At US,
focal granulomas are usually hypoechoic and their diameter is variable.
During CT examination,
small hypodense,
ill-defined lesions with contrast-enhancement may also be encountered.
Usually the granulomas do not enhance more than healthy spleen; however,
their attenuation is higher than that of splenic cysts [8].
In our experience,
splenic nodules became apparent as hypoattenuating lesions.
Contrast-enhanced abdominal CT scan showed...
Conclusion
Familiarity with the radiological features of splenic granulomas plays a crucial role in diagnosis and management.
References
[1] Elsayes KM1,
Narra VR,
Mukundan G,
Lewis JS Jr,
Menias CO,
Heiken JP.
MR imaging of the spleen: spectrum of abnormalities.
Radiographics. 2005 Jul-Aug;25(4):967-82.
[2] A.
Luna,
R.
Ribes,
P.
Caro,
L.
Luna,
E.
Aumente,
and P.
R.
Ros.
MRI of focal splenic lesions without and with dynamic gadolinium enhancement.
American Journal of Roentgenology,
vol.
186,
no.
6,
pp.
1533–1547,
2006.
[3] R.
C.
Semelka,
J.
P.
Shoenut,
P.H.
Lawrence,H.M.Greenberg,T.
P.Madden,
andM.
A.
Kroeker.
Spleen: dynamic enhancement patterns on gradient-echoMR images enhanced with gadopentetate...
