Скачать или смотреть Spleen 5/5: Vascular tumors - hemangioma, lymphangioma, littoral cell angioma, and angiosarcoma

Splenic hemangioma

Most common benign neoplasm
Second commonest focal lesion after splenic cysts
Solid mass with cystic spaces, may contain calcifications
Peripheral nodular enhancement is less conspicuous

Cystic appearance with septal enhancement

Growing cystic lesions

Solid appearance

Solid appearance


Splenic lymphangioma
Less common than hemangioma, mostly occur in children
Microcystic/solid c/s central scar, or large solitary cyst
Sharp margin, thin-walled cystic lesion, subcapsular
No significant contrast-filling
Microcystic lesions may mimic solid lesions

Littoral cell angioma
Generally considered benign, but may show malignant features
Multiple splenic lesions of similar size with hypersplenism
US: Mottled exchotexture, either iso/hypo/hyperechoic nodules.
CT: Progressive enhancement, become isointense on DP
MRI: Hypointense on T1 and T2WI due to hemosiderin


Splenic angiosarcoma
Very rare, but m.c. non-lymphoid, primary malignant tumor
More frequently in older patients
Various symptoms, splenomegaly, metastases
US: complex mass with heterogeneous texture
CT/MRI: Ill-defined, heterogeneous enh, necrosis, hemorrhage

Summary: Primary vascular tumor spleen
Hemangiomas & lymphangiomas
Mixed solid & cystic appearance
Hemangioma is more common, better enhancing
May not typical as hepatic hemangiomas
Littoral cell angioma: Hypersplenism & many, uniform nodules
Angiosarcoma
Markedly heterogeneous, metastases, hemorrhage, necrosis