Diagnostic Ultrasound - Abdomen and Pelvis

Splenic Tumors
Diagnoses: Spleen
(Left) Transverse
transabdominal ultrasound
shows an ill-defined splenic
lymphangioma ſt with a
cystic component st. (Right)
Corresponding color Doppler
ultrasound shows the splenic
lymphangioma ſt has
peripheral vascularity st and
avascular central cystic area.
(Left) Grayscale US shows a
large, ill-defined,
heterogeneous echogenicity,
cystic and solid mass replacing
the spleen. There are areas of
shadowing calcification .
Histology revealed
angiosarcoma. Evaluation of
the liver can be helpful as the
majority (> 70%) of splenic
angiosarcomas have hepatic
metastases on presentation.
(Right) Grayscale US of a cystic
mass ſt in the anterior aspect
of the spleen in a 45-year-old
woman is shown. Note the
solid internal components .
This was further worked-up
with MR and PET/CT.
(Left) Axial contrast-enhanced
MR image shows
enhancement of the solid
components along the
anteromedial aspect of the
cystic mass. At this stage, both
benign and malignant
etiologies can be considered.
(Right) Fused axial PET/CT in
the same patient shows
intense FDG avidity of the
solid components (SUV max
> 11). This lesion is suspicious
for malignancy (particularly
lymphoma or metastasis) and
will require tissue sampling for
final diagnosis.
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