42 Hemangioma of the Spleen

Clinical Presentation

A 34-year-old woman complains of nonspecific abdominal pain.

Fig. 42.1 Axial contrast-enhanced CT image shows an enhancing exophytic splenic lesion (arrow) arising from the inferior pole of the spleen.

An axial contrast-enhanced computed tomography (CT) image (Fig. 42.1) demonstrates a well-defined exophytic lesion arising from the inferior pole of the splenic parenchyma and shows homogeneous enhancement after contrast administration.

Diagnosis

Hemangioma of the spleen

Differential Diagnosis

Predominantly solid splenic lesions: hamartomas, lymphoma, metastasis, angiosarcoma, inflammatory pseudotumors, littoral cell angioma
Predominantly cystic lesions: cyst, abscess, lymphangioma

Discussion

Background

Hemangiomas represent the most common primary benign neoplasms of the spleen, being recognized in 0.3 to 14.0% of cases at autopsy. These lesions, which tend to be slightly more common in men, result from the proliferation of splenic vascular channels with endothelial lining and may undergo several changes, including fibrosis, hemorrhage, and necrosis; they usually tend to grow slowly, so that symptoms and complications, although unusual, manifest in late adulthood. The term hemangiomatosis refers to the presence of multiple hemangiomas within the splenic parenchyma; this condition may be part of a systemic angiomatosis as described in Klippel-Trénaunay-Weber, Turner, Kasabach-Merritt, and Beckwith-Wiedemann syndromes.