Aims and objectives
With ever-increasing use of cross-sectional imaging,
radiologists face with the challenge of characterizing incidental splenic lesions.
Most of the incidental splenic lesions on CT scan and MRI turn out to be benign in patients with no known malignancy.
In the other hand,
spleen is a relatively uncommon site for metastasis; therefore differentiating benign from malignant lesions is crucial in these instances.
[1-,
2]
Ultrasound-guided biopsy of splenic lesion is considered the diagnostic method of choice for problematic splenic lesions.
However,
limitations in spleen biopsy persuade...
Methods and materials
This retrospective study was performed in a tertiary referral center.
Data of patients with incidental spleen lesions in their cross sectional imaging were assessed.
Over a course of three years,
161 patients were included.
Follow-up imaging was performed in 122 individuals with mean (SD) follow-up time of 16.4 (16) months (ranged 1-96 months).
Patients’ demographic data,
morphologic features and enhancement patterns on available CT scan and MRI were carefully reviewed and compared.
Patients with histopathology report indicative of benign lesion,
negative history of malignancy or...
Results
Of 161 patients [54% males,
mean age (SD): 59.7 (15.4).
ranged: 8-88 yr.],
124 (77%) had benign lesions,
while 37 (23%) individuals were found out to have malignant lesion.
Benign lesions were more likely to be homogenous (59.7% vs.
29.7%,
p: 0.002).
(Table-1) Ill-defined and/or lobulated borders had significantly higher prevalence in malignant lesions (73% vs.
53.2%,
p: 0.03).
Malignant lesions had significantly larger size (21.7 vs.
15.5 mm,
p: 0.03).
None of the benign lesions showed restricted diffusion in DWI/ADC,
while 50% of malignant...
Conclusion
Radiologists are increasingly challenged by incidental splenic lesions on cross sectional imaging studies obtained for other various reasons.
The management of incidentally discovered splenic lesions remains a dilemma.
This study reviewed the importance of possibly helpful imaging features of splenic lesions.
Primary and secondary lesions of the spleen are thought to be rare,
however spleen is a hostile organ for metastases from breast,
colorectal,
ovarian carcinoma and melanoma.
[7,
8,
9]
We did not find lesion Hounsfield unit on non-contrast or contrast enhanced CT scan...
References
1.
Gomez-Rubio,
M.,
et al.,
Safety and diagnostic accuracy of percutaneous ultrasound-guided biopsy of the spleen: a multicenter study.
J Clin Ultrasound,
2009.
37(8): p.
445-50.
2.
Lieberman,
S.,
et al.,
Imaging-guided percutaneous splenic biopsy using a 20- or 22-gauge cutting-edge core biopsy needle for the diagnosis of malignant lymphoma.
AJR Am J Roentgenol,
2003.
181(4): p.
1025-7.
3.
Civardi,
G.,
et al.,
Ultrasound-guided fine needle biopsy of the spleen: high clinical efficacy and low risk in a multicenter Italian study.
Am J Hematol,
2001....