Fact-sheet: Splenic hamartoma
  • Splenoma


Updated on 09/20/2019 at 10:12 AM

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Definition

Primary benign tumor of the spleen (formerly called Splenoma) corresponding to a nodular hyperplasia composed exclusively of red pulp (+/- a calcified or necrotic component)

Prevalence of approximately 0.1% of the population

Sex ratio 1:1

Congenital

Clinical features

Asymptomatic, incidental finding.

In rare cases, a lesion responsible for abdominal pain if large

Laboratory findings

Usually no laboratory abnormalities

Rarely associated splenic sequestration (thrombocytopenia and anemia)

Radiography

Noncontributory

Ultrasound

Solitary nodule >> multiple

Size most often < 3 cm, but can be much larger

Iso- or hyperechoic nodule, homogeneous, solid, with more or less cystic or calcified changes

Doppler: hypervascular

CT

Well-defined nodule

Isodense to the spleen on unenhanced images. Enhancement kinetics identical to the spleen ("spleen within a spleen" appearance), with heterogeneous, predominantly peripheral enhancement during the parenchymal arterial phase, becoming homogeneous during the venous phase

The appearance of the lesion may be altered by cystic, hemorrhagic, or necrotic changes, sometimes with secondary calcifications

MRI

Isointense on T1, heterogeneous hyperintense on T2, heterogeneous enhancement during the parenchymal arterial phase, homogeneous during the venous or delayed phase, overall similar to the adjacent spleen except during the parenchymal arterial phase

Nuclear medicine

Not FDG-avid on 18F-FDG PET

Management

No treatment required

No follow-up required

Differential diagnosis

Other benign splenic lesion: cyst/hemangioma

Rarer malignant tumor of the spleen (especially in the absence of known malignancy)