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Contrast-enhanced sonography with Sonazoid as a new diagnostic tool for splenic hamartoma: a single case report

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Abstract

Detection of reticuloendothelial system (RES) cells is essential for the differential diagnosis of splenic hamartoma. Among the imaging techniques using contrast agents phagocytosed by RES cells, contrast-enhanced ultrasonography (CEUS) with Sonazoid is less invasive and less costly than 99mTc-labeled colloid scintigraphy. We report a case of non-symptomatic splenic hamartoma in a 40-year-old woman detected as an abdominal tumor by screening ultrasonography. The tumor was 4 cm in diameter, round, slightly hypoechoic, and associated with a cystic lesion. The tumor region was stained on enhanced computed tomography with prolonged enhancement, while the cystic lesion was not. The mass appeared as mainly isointense with partial hyperintensity on T1-weighted and as a mixed hypo- and hyperintense region on T2-weighted magnetic resonance images. 99mTc-labeled colloid scintigraphy demonstrated uptake in only the tumor region. CEUS with Sonazoid revealed that the tumor was mainly hypervascular with non-enhanced areas in the early vascular phase, but the hypervascular region appeared also as a hyperechoic area (indicating microbubble phagocytosis) in the post-vascular phase. Thus, CEUS with Sonazoid revealed all three cardinal features of splenic hamartoma: hypervascularity, presence of RES cells, and tissue heterogeneity. Splenectomy and histopathology confirmed the presence of a splenic hamartoma with associated hematoma. CEUS with Sonazoid is a promising new diagnostic tool for splenic hamartoma.

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Authors and Affiliations

  1. Division of Medicine and Clinical Science, Department of Multidisciplinary Internal Medicine, Tottori University Faculty of Medicine, 36-1 Nishimachi, Yonago, Tottori, 683-8504, Japan

    Takaaki Sugihara, Masahiko Koda & Yoshikazu Murawaki

  2. Department of Gastroenterology and Hepatology, Matsue Municipal Hospital, 32-1 Noshira-cho, Matsue, Shimane, 690-8509, Japan

    Jun Kato

  3. Division of Surgical Oncology, Department of Surgery, Tottori University Faculty of Medicine, 36-1 Nishimachi, Yonago, Tottori, 683-8504, Japan

    Teruhisa Sakamoto

  4. Department of Pathology, Tottori University Hospital, 36-1 Nishimachi, Yonago, Tottori, 683-8504, Japan

    Yasushi Horie

Authors
  1. Takaaki Sugihara
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  2. Masahiko Koda
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  3. Jun Kato
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  4. Teruhisa Sakamoto
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  5. Yasushi Horie
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  6. Yoshikazu Murawaki
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Correspondence to Takaaki Sugihara.

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Human rights statements and informed consent

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2008 (5). Informed consent was obtained from the patient for being included in this report.

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Sugihara, T., Koda, M., Kato, J. et al. Contrast-enhanced sonography with Sonazoid as a new diagnostic tool for splenic hamartoma: a single case report. J Med Ultrasonics 43, 113–118 (2016). https://doi.org/10.1007/s10396-015-0660-2

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  • DOI: https://doi.org/10.1007/s10396-015-0660-2

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