Abstract
Splenic lymphangiomas are rare benign tumors occurring more frequently in children. Because of their asymptomatic growth, splenic lymphangiomas are usually suspected based on incidental findings, the diagnosis relying on different imaging techniques and requiring histological confirmation. The rarity of the disease and its atypical imaging findings make the diagnosis of splenic lymphangiomas challenging. We describe the case of an isolated splenic cystic lymphangioma affecting an elderly female patient. The patient was asymptomatic and the blood tests were normal. The tumor appeared on gray-scale ultrasound as an inhomogeneous, mostly hyperechoic septated mass, which is atypical for a cystic lymphangioma. Contrast-enhanced ultrasound and contrast-enhanced computed tomography suggested the benign nature of the tumor and narrowed the diagnosis. The tumor received histopathological confirmation after splenectomy. Various CT and MRI findings in splenic lymphangiomas have been described, but very few reports regarding CEUS exist to this point.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Chung SH. Asymptomatic lymphangioma involving the spleen and retroperitoneum in adults. World J Gastroenterol. 2009;15:5620.
Goh BK, Tan YM, Ong HS, et al. Intra-abdominal and retroperitoneal lymphangiomas in pediatric and adult patients. World J Surg. 2005;29:837–40.
Kosir MA, Sonnino RE, Gauderer MW. Pediatric abdominal lymphangiomas: a plea for early recognition. J Pediatr Surg. 1991;26:1309–13.
Ioannidis I, Kahn AG. Splenic Lymphangioma. Arch Pathol Lab Med. 2015;139:278–82.
Eghtedari M, Sicklick J, Kono Y, et al. Unusual imaging profile of a solitary splenic lymphangioma. Acta Radiol Short Rep. 2012;1:27.
Yu X, Yu J, Liang P, et al. Real-time contrast-enhanced ultrasound in diagnosing of focal spleen lesions. Eur J Radiol. 2012;81:430–6.
Abbott RM, Levy AD, Aguilera NS, et al. From the archives of the AFIP: primary vascular neoplasms of the spleen: radiologic–pathologic correlation. Radiographics. 2004;24:1137–63.
Wadsworth DT, Newman B, Abramson SJ, et al. Splenic lymphangiomatosis in children. Radiology. 1997;202:173–6.
Patti R. Splenic lymphangiomatosis showing rapid growth during lactation: a case report. World J Gastroenterol. 2010;16:1155.
Quack Loetscher KC, Jandali AR, Garzoli E, et al. Axillary cavernous lymphangioma in pregnancy and puerperium. Gynecol Obstet Invest. 2005;60:108–11.
Komatsuda T, Ishida H, Konno K, et al. Splenic lymphangioma: US and CT diagnosis and clinical manifestations. Abdom Imaging. 1999;24:414–7.
Solomou EG, Patriarheas GV, Mpadra FA, et al. Asymptomatic adult cystic lymphangioma of the spleen: case report and review of the literature. Magn Reson Imaging. 2003;21:81–4.
Mohammadi A, Ghasemi-rad M, Abassi F. Asymptomatic lymphangioma involving the spleen and mediastinum in adults. Med Ultrason. 2013;15:154–6.
Bader TR, Ranner G, Klimpfinger M. Case report: CT appearance of capillary and cavernous lymphangiomatosis of the spleen in an adult. Clin Radiol. 1998;53:379–81.
Bezzi M, Spinelli A, Pierleoni M, et al. Cystic lymphangioma of the spleen: US–CT–MRI correlation. Eur Radiol. 2001;11:1187–90.
Beltran MA, Barria C, Pujado B, et al. Gigantic cystic splenic lymphangioma. Report of one case. Rev Med Chil. 2009;137:1597–601.
Vezzoli M, Ottini E, Montagna M, et al. Lymphangioma of the spleen in an elderly patient. Haematologica. 2000;85:314–7.
Dietz WH Jr, Stuart MJ. Splenic consumptive coagulopathy in a patient with disseminated lymphangiomatosis. J Pediatr. 1977;90:421–3.
Barrier A, Lacaine F, Callard P, et al. Lymphangiomatosis of the spleen and 2 accessory spleens. Surgery. 2002;131:114–6.
Crema E, Etchebehere RM, Gonzaga MN, et al. Splenic lymphangioma: a rare benign tumor of the spleen treated by laparoscopic surgery. Arq Bras Cir Dig. 2012;25:178–9.
Chang WC, Liou CH, Kao HW, et al. Solitary lymphangioma of the spleen: dynamic MR findings with pathological correlation. Br J Radiol. 2007;80:e4–6.
Yang F, Chen WX. Splenic lymphangioma that manifested as a solid-cystic mass: a case report. World J Gastroenterol. 2013;19:781–3.
Barbaros U, Deveci U, Ozluk Y, et al. Laparoscopic treatment of splenic lymphangiomas: report of three cases. G Chir. 2007;28:403–6.
Acknowledgments
We would like to thank Mrs. Szasz Zsoka and Ms. Hosu Miana for collecting the images.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
Andrei Roman, Cornel Iancu, Vasile Andreica, Mihai Socaciu, Ofelia Anton, Roxana Sechel, and Radu Badea declare that they have no conflict of interest.
Human rights 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 all patients for being included in the study.
About this article
Cite this article
Roman, A., Iancu, C., Andreica, V. et al. Splenic cystic lymphangioma with atypical ultrasound findings. J Med Ultrasonics 43, 99–105 (2016). https://doi.org/10.1007/s10396-015-0659-8
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10396-015-0659-8