Fact-sheet: Splenic hemangioma


Updated on 08/26/2020 at 2:42 PM

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Definition

Most common benign solid lesion of the spleen.
Non-encapsulated vascular tumor.
Several histologic subtypes (mainly cavernous and capillary)

Clinical features

Asymptomatic / incidental finding.

Laboratory findings

Not disturbed.

Radiography

Not contributory.

Ultrasound

  • Cavernous hemangioma:
    hypoechoic, with cystic areas or entirely cystic
  • Capillary hemangioma:
    isoechoic, or round or irregular hyperechoic with well-defined margins.
  • Color Doppler:
    peripheral or central vessels.

CT

Similar to Hepatic hemangioma:

- Mildly hypodense on unenhanced images.
- Progressive, patchy, peripheral, nodular, discontinuous enhancement starting on the arterial phase, without washout, complete on delayed acquisitions.
- Central calcifications

MRI

  • T1: variable signal depending on content
  • T2: marked hyperintensity
  • Post-contrast: non-characteristic kinetics.
    Inconsistent centripetal enhancement.
    Homogeneous enhancement, no patchy enhancement.

Management

No treatment.
No follow-up.

Differential diagnosis

Special cases: Klippel-Trenaunay-Weber syndrome and Kasabach-Merritt syndrome.

Benign: hamartoma / lymphangioma / SANT.
Intermediate: littoral cell angioma, Hemangiopericytoma.
Malignant: Angiosarcoma / Spleen metastasis.