Spleen Flashcards
accessory spenule clinical sigificance
mistaken for LN/mass; should follow spleen MR signal on all sequences
splenectomy for consumptive thrombocytopenia may not be curative if residual tissue present
polysplenia syndrome
visceral heterotaxia with multiple foci of splenic tissue ; same side as stomach
associated with cardiac anomalies, iterruption of IVC with azygos/heiazygos continuation; preduodenal portal vein
wandering spleen
abnormal laxity/absence of fixed ligamentous attachments for spleen
splenic hemangioma
most common benign splenic neoplasm
associated with phleboliths and visceral hemangiomatosis syndromes (Kasabach Merrit and Klippel Trenaunay Weber syndrome )
Kasabach Merrit syndrome
visceral hemangiomatosis;
anemia, thrombocytopenia, consumptive coagulopathy
Klippel Trenaunay Weber
visceral hemangiomatosis;
cutaneous hemangioma, varicose veins, extremity hypertrophy
splenic hemangioma imaging
T2 hyperintense, peripheral/homogenous enhancement
CT: iso/hypoattenuating noncontrast; hyperenhancing
splenic hamartoma
malformed red pulp; associated with TS
splenic hamartoma imaging
well-circumscribed iso/hypoattenuating mass
heterogenous enhancement after CT administration
T2 hyperintense
benign splenic lesions
epithelial cyst, pseudocyst, intrasplenic pancreatic pseudocyst, lymphangioma
congenital cyst
epithelial lining; may cause elevation of CA19-9 or CA125, CEA
may have septation, but no mural calcifications
postraumatic pseudocyst
end result of evolving splenic hamartoma
fibrotic tissue surrounds; mural calcification; no septations; no peripheral enhancement (fibrotic)
intrasplenic pancreatic pseudocyst
tail of pancreas pseudocyst extends into spleen (history of pancreatitis)
lymphangioma
rare benign lesion typically diagnosed in chidhood; solitary or multiple
multilocular cystic struction with thin septations; septal enhancement?
splenic sarcoidosis
multiple nodules with noncaseating granulomas; 1-3cm without enhancement and become coalescent;
splenomegaly (hepatomegaly and LN too)
inflammatory pseudotumor
focal collection of immune cells and inflammatory exudate; unclear etiology
well circumscribed heterogenously enhancing mass
splenic infections
pyogenic, fungal, parasitic infections
fungal splenic abscesses
multiple, small <1 cm
immunocompromised
Candida, Aspergillus, Crytpococcus; pneumocystis jiroveci seen with AIDS and is multiple calcified lesions
pyogenic abscess
solitary usually bacterial; irregular enhancing wall
wheel within wheel or bulls eye appearance
echinococcal cyst
echinococcus granulosa; usually with involvement elsewhere
true cyst with cellular lining; internal undulating membrane and daughter cysts
most common splenic malignancy
splenic lymphoma
solitary hypovascular mass; may extend beyond splenic capsule
lymphomatous involvement of spleen (secondary)
miliary masses, multiple small/moderate masses, one large mass, splenomegaly
T1 hypoenhancing
cystic appearance on US but internal flow on doppler
splenic mets
rare; likely due to antineoplastic properties of lympoid rich tissue
breast, lung, ovary, melanoma can met to spleen; ovarian/melanoma cause cystic mets
calcs rare unless mucinous adenocarcinoma
angiosarcoma
enlarged heterogenous mass replaces spleen; very agressive/poor prognosis
no established association with Thorotrast, vinyl chloride, arsenic
splenic infarct
emboli or thrombosis
wedge shaped peripheral region of nonenhancement
MR: T1 hyperinense/hemorrhagic; T1 hypointense/T2 hyperintense chronic
entire spleen hypoenhancement
complete infarction, possible wandering spleen/torsion
gamma gandy bodies
hemosiderin deposition from portal hypertension
low signal on all MR sequences; blooming artifact
Gaucher disease – spleen
AR; deficiency of glucocerebrosidase
Erlenmeyer flask deformity of distal femurs, AVN of femoral heads/endplates; splenomegaly; multiple splenic nodules
splenic trauma
MDCT grade I: Small (<1 cm) subcapsular hematoma, laceration, or parenchymal hematoma.
• MDCT grade II: Medium (>1 and <3 cm) subcapsular hematoma, laceration, or parenchymal hematoma.
• MDCT grade III: Splenic capsular disruption; or large (>3 cm) laceration or parenchymal hematomas.
• MDCT grade IVA: Active extravasation, vascular injury (pseudoaneurysm or arteriovenous fistula), or shattered spleen.
• MDCT grade IVB: Active intraperitoneal bleeding.
