Diagnostic Ultrasound - Abdomen and Pelvis

Splenic Tumors
(Left) A solid, hypoechoic mass
in the spleen consistent
with a solitary lymphomatous
deposit is shown. Note the
indistinct margins ,
characteristic of this entity.
Lymphoma can present with
diffuse involvement, solitary
focal lesion, or multifocal
lesions. (Right) Longitudinal
transabdominal ultrasound
shows multiple hypoechoic
lesions ſt in a patient with
multifocal lymphomatous
involvement of the spleen.
Diagnoses: Spleen
(Left) Transverse
transabdominal US shows a
solitary, hypoechoic splenic
metastasis ſt. Metastases
may vary from a target
appearance to a uniform iso-
/hypo-/hyperechoic lesion or
heterogeneous mass. This may
be difficult to differentiate
from entities such as
lymphoma; clinical history is
helpful. (Right) Multifocal
hypoechoic spleen lesions ſt,
of varying sizes and some with
indistinct margins,
representing melanoma
metastases, are shown. Note:
Melanoma metastases can
also present as cystic masses.
(Left) Color Doppler US image
shows multiple hypoechoic
granulomas ſt, without
internal vascularity. Note the
normal splenic parenchymal
vascularity st. On US, splenic
granulomas (TB, MAC, sarcoid)
appear as multiple small, welldefined,
hypoechoic lesions,
which may mimic lymphoma
or metastasis. (Right) Axial
CECT in the same patient
shows no enhancement within
the hypodense splenic
granulomas ſt. Focal
calcification is noted as
well, which can be seen with
granulomatous disease.
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