Spleen Flashcards
Multiple targetoid/bulls eye lesions in spleen ddx
Mets
Lymphoma
Candida microabscess
Whats the next step in suspected candida microabscesses with a negative sonogram?
MRI
Which echinococcus presents with sharply defined cysts and daughter cysts? Which one with tiny cystic masses resembling malignancy?
Granulosus has daughter cysts
Multilocularis has cystic masses
DDx for calcified splenic cystic lesion?
Echinococcus
Traumatic cyst
Splenic aneurysm
Why is an echinoccocal cyst slightly higher attenuation than water?
Inflammatory cells and hydatid sand
What is the differential for multiple splenic calcifications?
Healed granulomatous infection Candida microabscesses Extrapulmonary pneumocystis Treated lymphoma Treated mets
How would sarcoid present in the spleen?
Multiple hypoattenuating lesions and/or hepatosplenomegaly
What is the most common benign tumor in the spleen?
Hemangioma
What is kasabach merrit syndrome?
Anemia, infarction, high output CHF, thrombocytopenia, coagulopathy
seen with large hemangiomas
Heterogeneous mass on CT/US?
Hemangioma
What are 3 associations with splenic hemangiomas
Klippel trenauny weber
Kasabach merrit
Portal venous hypertension
What are the two types of splenic cyst?
True (with cellular lining) and false (without a cellular lining)
What are the causes of false splenic cysts?
Trauma, infarction, infection
What is a hamartoma?
Normal cellular elements in abnormal quantity, degree of differentiation, and/or cellular arrangment.
What is the association with splenic hamartomas?
Hypersplenism
What is an inflammatory pseudotumor?
Localized area of inflammatory and fibroblastic cells surrounding regions of hemorrhage and necrosis
What is the ddx for a well circumscribed heterogeneously enhancing mass within the spleen
Lymphoma Mets Hemangioma Inflammatory pseudotumor Hamartoma
What are gamma gandy bodies? how do they look on MRI?
Seen in cirrhosis and portal venous hypertension, these develop from prior organized hemorrhage.
Dark on T1 and T2 and bright in gradient echo
What is the imaging progression of splenic infarct on US?
Acute - poorly delineated hypoechoic region
Chronic - well marginated and hyperechoic
What is the most common malignant tumor in the spleen?
Lymphoma
What are the 4 patterns of splenic lymphoma
homogenous enhancement
miliary involvement
multiple masses
solitary large mass
How do melanoma mets present in the spleen?
Cystic necrosis with fluid centrally or a sonographic halo around the mass circumference
What is the blood supply of the spleen
Splenic artery and short gastric
Differentiate primary from secondary hemochromatosis
Primary will involve the pancreas and rarely involve the spleen
Secondary will involve the spleen and spare the pancreas
