Splenic hemangioma

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[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.

[edit] Imaging Findings for Splenic hemangioma

  • 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,

[edit] Images

Patient #1

[edit] External Links

[edit] References for Splenic hemangioma