Splenic hemangioma

[edit] Discussion of Splenic hemangioma

Most common benign primary neoplasm of the spleen.
Prevalence at autopsy ranges from 0.3% to 14%
Most often in adults from mid-30s to mid-50s years of age.
Most hemangiomas are small lesions that are found incidentally and patients usually have no symptoms.
Natural course of hemangiomas is slow growth
Symptoms or complications, when present, occur late.
- Hemangiomas can become large and manifest as a palpable nontender mass in the left upper quadrant.
- Complications include rupture, hypersplenism, and malignant degeneration.
- Kasabach-Merritt syndrome (anemia, thrombocytopenia, and coagulopathy) has been reported in patients with large hemangiomas.

Usually a hemangioma appears as a solid mass with cystic spaces.
On radiographs, the lesion may manifest as a mass in the left upper quadrant or as splenomegaly. Calcification, when present, appears as multiple small punctate calcifications or peripheral curvilinear calcifications.
On sonograms, a hemangioma may manifest as a well-defined intrasplenic or pedunculated echogenic solid or complex cystic mass. Echogenic calcifications with acoustic shadowing may be present.
On unenhanced CT scans, capillary hemangiomas appear as hypoattenuating or isoattenuating, well-marginated masses. Homogeneous and marked contrast enhancement occurs during intravenous administration of contrast material.
The MR imaging appearance of splenic hemangiomas has been described as being similar to that of hepatic hemangiomas. Splenic hemangiomas are hypo- to isointense, compared with normal spleen, on T1-weighted images and hyperintense on T2-weighted images. Dynamic MR imaging after administration of gadopentetate dimeglumine has shown that splenic hemangiomas have three patterns of enhancement: (a) immediate homogeneous enhancement that persists, (b) early peripheral enhancement with uniform delayed enhancement, and (c) peripheral enhancement with centripetal progression but persistent enhancement of a central fibrous scar,

Patient #1

Robert M. Abbott, Angela D. Levy, Nadine S. Aguilera, Luis Gorospe, and William M. Thompson. From the Archives of the AFIP: Primary Vascular Neoplasms of the Spleen: Radiologic-Pathologic Correlation. RadioGraphics 2004 24: 1137-1163.