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Current Management of the Splenic Incidentaloma

  • Liver and Gastrointestinal Imaging (J Olpin, Section Editor)
  • Published:
Current Radiology Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

Focal lesions of the spleen are being detected at an ever-increasing rate given the constant improvement in temporal and spatial resolution of computed tomography (CT) and magnetic resonance (MR) imaging. Many commonly encountered benign “incidentalomas” of the spleen present as non-specific lesions that are hypoattenuating relative to the background normal splenic parenchyma on CT. Incidentally detected lesions can lead to increased patient anxiety, while posing challenges in patient management for practicing radiologists and clinicians.

Recent Findings

While the literature regarding incidentally detected splenic lesions has previously been relatively scarce, recent consensus criteria have emerged in recent years that greatly aid in the characterization and management of such lesions. This article discusses the diagnosis and management of incidentally detected splenic lesions based on recently consensus criteria.

Summary

This review is intended to aid clinical radiologists in the characterization, differentiation and management of incidentally detected splenic lesions.

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References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. Paluska TR, Sise MJ, Sack DI, Sise CB, Egan MC, Biondi M. Incidental CT findings in trauma patients: incidence and implications for care of the injured. J Trauma. 2007;62(1):157–61.

    Article  Google Scholar 

  2. • Ahmed S, Horton KM, Fishman EK. Splenic incidentalomas. Radiol Clin North Am. 2011;49(2):323–47. This publication provides a comprehensive description of incidentally detected splenic lesions.

  3. •• Heller MT, Harisinghani M, Neitlich JD, Yeghiayan P, Berland LL. Managing incidental findings on abdominal and pelvic CT and MRI, part 3: white paper of the ACR Incidental Findings Committee II on splenic and nodal findings. J Am Coll Radiol. 2013;10(11):833–9. Current guidelines from the ACR consensus criteria greatly aid in the diagnosis and management of incidentally detected splenic masses.

  4. Urrutia M, Mergo PJ, Ros LH, Torres GM, Ros PR. Cystic masses of the spleen: radiologic-pathologic correlation. Radiographics. 1996;16(1):107–29.

    Article  CAS  PubMed  Google Scholar 

  5. Dawes LG, Malangoni MA. Cystic masses of the spleen. Am Surg. 1986;52(6):333–6.

    CAS  PubMed  Google Scholar 

  6. Ros PR, Moser RP Jr, Dachman AH, Murari PJ, Olmsted WW. Hemangioma of the spleen: radiologic-pathologic correlation in ten cases. Radiology. 1987;162(1 Pt 1):73–7.

    Article  CAS  Google Scholar 

  7. Elsayes KM, Narra VR, Mukundan G, Lewis JS Jr, Menias CO, Heiken JP. MR imaging of the spleen: spectrum of abnormalities. Radiographics. 2005;25(4):967–82.

    Article  PubMed  Google Scholar 

  8. Ramani M, Reinhold C, Semelka RC, Siegelman ES, Liang L, Ascher SM, et al. Splenic hemangiomas and hamartomas: MR imaging characteristics of 28 lesions. Radiology. 1997;202(1):166–72.

    Article  CAS  PubMed  Google Scholar 

  9. Ferrozzi F, Bova D, Draghi F, Garlaschi G. CT findings in primary vascular tumors of the spleen. AJR Am J Roentgenol. 1996;166(5):1097–101.

    Article  CAS  Google Scholar 

  10. Rabushka LS, Kawashima A, Fishman EK. Imaging of the spleen: CT with supplemental MR examination. Radiographics. 1994;14(2):307–32.

    Article  CAS  Google Scholar 

  11. Ohtomo K, Fukuda H, Mori K, Minami M, Itai Y, Inoue Y. CT and MR appearances of splenic hamartoma. J Comput Assist Tomogr. 1992;16(3):425–8.

    Article  CAS  PubMed  Google Scholar 

  12. Solomou EG, Patriarheas GV, Mpadra FA, Karamouzis MV, Dimopoulos I. Asymptomatic adult cystic lymphangioma of the spleen: case report and review of the literature. Magn Reson Imaging. 2003;21(1):81–4.

    Article  CAS  Google Scholar 

  13. Abbott RM, Levy AD, Aguilera NS, Gorospe L, Thompson WM. From the archives of the AFIP: primary vascular neoplasms of the spleen: radiologic-pathologic correlation. Radiographics. 2004;24(4):1137–63.

    Article  PubMed  Google Scholar 

  14. Falk S, Stutte HJ, Frizzera G. Littoral cell angioma. A novel splenic vascular lesion demonstrating histiocytic differentiation. Am J Surg Pathol. 1991;15(11):1023–33.

    Article  CAS  PubMed  Google Scholar 

  15. Lashbrook DJ, James RW, Phillips AJ, Holbrook AG, Agombar AC. Splenic peliosis with spontaneous splenic rupture: report of two cases. BMC Surg. 2006;6:9.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Martel M, Cheuk W, Lombardi L, Lifschitz-Mercer B, Chan JK, Rosai J. Sclerosing angiomatoid nodular transformation (SANT): report of 25 cases of a distinctive benign splenic lesion. Am J Surg Pathol. 2004;28(10):1268–79.

    Article  PubMed  Google Scholar 

  17. Falk GA, Nooli NP, Morris-Stiff G, Plesec TP, Rosenblatt S. Sclerosing Angiomatoid Nodular Transformation (SANT) of the spleen: case report and review of the literature. Int J Surg Case Rep. 2012;3(10):492–500.

    Article  Google Scholar 

  18. Bowerson M, Menias CO, Lee K, Fowler KJ, Luna A, Yano M, et al. Hot spleen: hypervascular lesions of the spleen. Abdom Imaging. 2015;40(7):2796–813.

    Article  Google Scholar 

  19. Bean MJ, Horton KM, Fishman EK. Concurrent focal hepatic and splenic lesions: a pictorial guide to differential diagnosis. J Comput Assist Tomogr. 2004;28(5):605–12.

    Article  PubMed  Google Scholar 

  20. Zia H, Zemon H, Brody F. Laparoscopic splenectomy for isolated sarcoidosis of the spleen. J Laparoendosc Adv Surg Tech A. 2005;15(2):160–2.

    Article  Google Scholar 

  21. Warshauer DM, Molina PL, Hamman SM, Koehler RE, Paulson EK, Bechtold RE, et al. Nodular sarcoidosis of the liver and spleen: analysis of 32 cases. Radiology. 1995;195(3):757–62.

    Article  CAS  PubMed  Google Scholar 

  22. Berge T. Splenic metastases: frequencies and patterns. Acta Pathol Microbiol Scand A. 1974;82(4):499–506.

    CAS  PubMed  Google Scholar 

  23. Rane SR, Bagwan IN, Pingle P, Holla VV. Splenic tumours–autopsy study of ten years. Indian J Pathol Microbiol. 2005;48(2):186–9.

    Google Scholar 

  24. Lucey BC, Boland GW, Maher MM, Hahn PF, Gervais DA, Mueller PR. Percutaneous nonvascular splenic intervention: a 10-year review. AJR Am J Roentgenol. 2002;179(6):1591–6.

    Article  PubMed  Google Scholar 

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Correspondence to Jeffrey Dee Olpin.

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Conflict of interest

Jeffrey D. Olpin is a section editor for Current Radiology Reports.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

Additional information

This article is part of the Topical Collection on Liver and Gastrointestinal Imaging.

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Olpin, J.D. Current Management of the Splenic Incidentaloma. Curr Radiol Rep 5, 23 (2017). https://doi.org/10.1007/s40134-017-0214-z

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  • DOI: https://doi.org/10.1007/s40134-017-0214-z

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