Primary Angiosarcoma of the Spleen

BackgroundAs the largest single lymphatic organ in the human body, the spleen is responsible for central immunological and haematological tasks. Therefore, the spleen can be subject to a wide range of pathologic disorders. Computed tomography (CT) represents the most widely applied cross-sectional abdominal imaging technique and is considered the imaging modality of choice for the evaluation of numerous abdominal pathological conditions. Hypodense splenic lesions are frequently encountered on abdominal CT images. Although most hypodense lesions of the spleen can be considered benign, some findings and clinical conditions warrant closer attention to the lesion. CT offers a number of morphological criteria that can be applied to differentiate hypodense lesions of the spleen, such as a the appearance of a lesion’s borders, its attenuation, as well as the presence of calcifications or solid components.MethodsThis article reviews the most common splenic pathologies leading to hypodense appearances on CT images and illustrates the key CT imaging findings in the context of the clinical history of the patients.ConclusionThe key imaging findings of hypodense splenic lesions are presented in order to aid interpretation during routine evaluation of abdominal CT images.Teaching Points• Haemangiomas, congenital in origin, represent the most common benign lesions of the spleen.• Lymphoma represents the most common malignant tumour of the, usually secondarily involved, spleen.• Most hypodense splenic lesions on CT represent benign lesions that require no further work-up.• For correct interpretation, hypodense splenic lesions need to be evaluated in the clinical context.

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“…Either solitary or multiple, contrast-enhancing lesions can be seen on CT [50–52]. The enhancement can be similar to that of haemangiomas.…”

Section: Angiosarcomamentioning

confidence: 99%

Computed tomography of the spleen: how to interpret the hypodense lesion

et al. 2012

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“…Other primary nonlymphoid malignant splenic tumors are extremely rare (Table 2). Hemangiosarcomas are highly aggressive neoplasms and the prognosis is poor [80]. Hemangiosarcomas are known to exhibit a high rate of bleeding and spontaneous rupture of the spleen [74,80].…”

Section: Splenic Tumorsmentioning

confidence: 99%

“…Hemangiosarcomas are highly aggressive neoplasms and the prognosis is poor [80]. Hemangiosarcomas are known to exhibit a high rate of bleeding and spontaneous rupture of the spleen [74,80]. Computed tomography may demonstrate a diffuse, poorly defined focal mass of heterogeneous or low attenuation in an enlarged spleen with occasional intratumoural necrosis and subcapsular or extracapsular blood collections [74,81].…”

Section: Splenic Tumorsmentioning

confidence: 99%

“…Sometimes hemangiosarcomas appear as multiple hypo-or hyperattenuating masses of varying size with poor contrast enhancement (Fig. 15) [80,81].…”

Section: Splenic Tumorsmentioning

confidence: 99%

“…Ultrasound may demonstrate an enlarged spleen with multiple hyperechoic masses or a solitary mass with a complex echo pattern [80,81]. The appearance on MR images is not characteristic and may exhibit as multiple hypointense masses on T1-and T2-weighted sequences [64,80].…”

Section: Splenic Tumorsmentioning

confidence: 99%

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Radiology of the spleen

2001

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The spleen is generally not considered a challenge to the radiologist. Most often it poses a problem by anomalies or an irregular but normal contrast enhancement; however, a variety of inflammatory, infectious and neoplastic diseases may involve the spleen. CT and ultrasonography are screening modalities for the spleen. For problem solving, MR imaging can be helpful, especially due to its free choice of the imaging plane and because of the high resolution in contrast MR imaging. Splenic angiography as a diagnostic tool has generally been replaced by CT, ultrasound, or MR and is now used as an interventional method, e. g., in non-surgical management of patients with chronic idiopathic thrombocytopenia or in patients with splenic trauma. This article reviews the radiology of the spleen, including anatomy, embryology, splenomegaly, splenic injury, infarction, cysts, tumors, abscesses, sarcoidosis, and AIDS. Knowledge about the use of different imaging modalities and underlying gross and microscopic pathologic features leads to a better understanding of the radiologic findings.

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Color Doppler sonographic findings in splenic hamartoma

Tang

Shimizu

Kikuchi

et al. 2000

J. Clin. Ultrasound

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We present the gray‐scale and color Doppler sonographic findings in a case of a splenic hamartoma in a 40‐year‐old man. Gray‐scale sonograms showed a 2 × 2 cm, hypoechoic splenic mass that was homogeneous without evidence of cystic change or calcification. Color Doppler sonograms showed multiple radial blood‐flow signals inside the mass, and spectral analysis confirmed arterial and venous flow. Arteriograms showed multiple small, hypervascular masses with fine tumor vessels and tumor stains within the spleen. Histologic analysis following a splenectomy showed dilated vessels and congestion consistent with the color Doppler sonographic findings. © 2000 John Wiley & Sons, Inc. J Clin Ultrasound 28:249–253, 2000.

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Primary Angiosarcoma of the Spleen

Cited by 19 publications

References 8 publications

Computed tomography of the spleen: how to interpret the hypodense lesion

Computed tomography of the spleen: how to interpret the hypodense lesion

Radiology of the spleen

Color Doppler sonographic findings in splenic hamartoma

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