Spleen: Differential Diagnosis





Imaging Abnormalities




Box 107-1

Congenital Syndromes with Splenomegaly





  • Aase-Smith syndrome



  • α 1 -Antitrypsin syndrome



  • Anemia (e.g., thalassemia, sickle cell, pyruvate kinase deficiency)



  • Chédiak-Higashi syndrome



  • Cogan’s syndrome



  • Ethanolamniosis



  • Farber’s syndrome



  • Felty’s syndrome



  • Fetal infection (e.g., herpes simplex, rubella, cytomegalovirus infection)



  • Gaucher’s disease, types I and III



  • Gangliosidosis (e.g., GM 1 , GM 2 )



  • Hepatic fibrosis and renal cystic disease



  • Hyperlipoproteinemia



  • Lipoatrophic diabetes



  • Mucopolysaccharidosis



  • Niemann-Pick disease



  • Osteopetrosis



  • Rubella syndrome



  • Sea-blue histiocyte syndrome



  • Vaquez-Osler syndrome




Box 107-2

Small Spleen





  • Inflammatory bowel disease



  • Hereditary hypoplasia



  • After irradiation



  • Infarction



  • Polysplenia syndrome



  • Sickle cell anemia






Ultrasound




Box 107-3

Increased Splenic Echogenicity

Diffuse





  • Polycythemia



  • Sarcoidosis



  • Leukemia



  • Tuberculosis



  • Malaria



  • Brucellosis




Box 107-4

Decreased Splenic Echogenicity

Diffuse





  • Congestion from portal hypertension



  • Leukemia



  • Lymphoma



  • Multiple myeloma




Box 107-5

Multifocal Hypoechoic Splenic Masses





  • Abscesses (e.g., pyogenic, fungal)



  • Metastases



  • Septic emboli



  • Infarction



  • Lymphoma



  • Cysts (e.g., simple, epidermoid, hydatid, pancreatic)



  • Lymphangiomatosis



  • Granulomatous disease (e.g., tuberculosis, Mycobacterium avium-intracellulare infection, sarcoidosis, cat-scratch disease)



  • Hamartoma, hemangioma



  • Splenic artery aneurysm



  • Disseminated Pneumocystis carinii ( Pneumocystis jiroveci ) infection




Box 107-6

Echogenic Splenic Masses





  • Hereditary spherocytosis



  • Infarct (chronic)



  • Hematoma



  • Metastases



  • Calcified granulomas



  • Plasmacytoma



  • Abscess with air bubbles



  • Schistosomiasis



  • Cholesterol crystals in simple cyst



  • Hydatid “sand” in hydatid cyst




Box 107-7

Solid Heterogeneous Splenic Masses





  • Hematoma



  • Abscess



  • Infarct



  • Angiosarcoma



  • Hemangioma



  • Hemangiosarcoma



Jun 23, 2019 | Posted by in GASTROINTESTINAL IMAGING | Comments Off on Spleen: Differential Diagnosis

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