Multimodality imaging of splenic lesions and the role of non-vascular, image-guided intervention

Abstract

Splenic lesions are often incidentally detected on abdominal-computed tomography (CT), ultrasound, or magnetic resonance imaging (MRI), and these can pose a diagnostic challenge in patients with suspected or known malignancy. This review will discuss the multimodality imaging features of various benign and malignant splenic pathologies including trauma, infection, infarct, granulomatous disease, benign neoplasms such as hemangioma, hamartoma, and littoral cell angioma, cystic entities such as peliosis, splenic cysts, and pseudocysts, and malignant processes such as metastasis, lymphoma, angiosarcoma, and leiomyosarcoma. While several of these splenic pathologies have characteristic imaging features that are helpful in diagnosis, others have nonspecific findings. In such clinical dilemmas, image-guided intervention may be essential, and we therefore discuss the role of non-vascular, image-guided splenic interventions for diagnostic and therapeutic purposes. The radiologist can play a key part in the clinical diagnosis and management of splenic lesions, and therefore a thorough knowledge of the imaging features of splenic lesions and a thoughtful approach to their management is crucial.

Inflammatory Pseudotumor-like Follicular Dendritic Cell Tumor of the Spleen: Case Report and Review of the Literature

“…Splenic metastases show usually minimal to heterogeneous centripetal enhancement that depends on the primary neoplasm. 17 Pathological findings of splenic metastases have also been reported. 18 However, we found no report concerning the peritumoral fibrous capsule of splenic metastases.…”

Non-occlusive Mesenteric Ischemia after Splenic Metastasectomy for Small-Cell Lung Cancer

“…Lesions that are very likely to be metastases require further intervention. However, it is difficult to diagnose splenic lesions accurately using multimodality imaging techniques, including CT, ultrasound and magnetic resonance imaging (12). The lesion in the present case may have been infectious, such as an abscess or other malignancy, as it did not respond to chemotherapy compared with the intrathoracic lesions.…”

Significance of Calcification in Sclerosing Angiomatoid Nodular Transformation: Little-Known but Meaningful Imaging Finding

“…Gutzeit A et al [12] showed a case of SANT diagnosed by means of ultrasoundguided core needle biopsy without complications. Recent studies demonstrated lower complication rates in image-guided splenic biopsy [13]. On the other hand, it should be noted that some cases of SANT can gradually increase in size during the follow-up period, despite its benign etiology [10].…”