Computed tomography of the spleen: how to interpret the hypodense lesion

Karlo, Christoph A.; Stolzmann, Paul; Do, Richard K.; Alkadhi, Hatem

doi:10.1007/s13244-012-0202-z

Table 1 Differential CT imaging features of hypodense lesions of the spleen

From: Computed tomography of the spleen: how to interpret the hypodense lesion

	Distribution	Number of lesions	Margin	Mass effect	Contrast enhancement	Spleen size	Patient history
Parasitic cyst	Random	Solitary	Well-defined	None	None	Normal	Hydatid disease (lung, liver)
Parasitic cyst	Random	Multiple	Well-defined	None	None	Normal	Hydatid disease (lung, liver)
Congenital cyst	Random	Solitary	Well-defined	Possible	Trabeculae	Normal	–
Neoplastic cyst	Random	Solitary	Well-/ill-defined	None	Yes	Normal	Primary tumour
Neoplastic cyst	Random	Multiple	Well-/ill-defined	None	Yes	Normal	Primary tumour
False cyst	Subcapsular	Solitary	Well-defined	None	None	Normal	Past splenic trauma
Traumatic injury	Random	Solitary	Ill-defined	Possible	None	Normal	Trauma
Traumatic injury	Random	Multiple	Ill-defined	Possible	None	Normal	Trauma
Pyogenic abscess	Random	Solitary	Ill-defined	Possible	Rim enhancement	Normal	Infectious condition (localised/systemic)
Pyogenic abscess	Random	Multiple	Ill-defined	Possible	Rim enhancement	Normal	Infectious condition (localised/systemic)
Sickle cell disease	Random	Multiple	Ill-defined	None	None	Normal (early stage)	Sickle cell disease
Sickle cell disease	Random	Multiple	Ill-defined	None	None	Small (late stage)	Sickle cell disease
Infarction	Oriented towards capsule	Solitary	Well-/ill-defined	None	Prolonged	Normal	Left upper quadrant pain
Infarction	Oriented towards capsule	Multiple	Well-/ill-defined	None	Prolonged	Normal	Thromboembolic disease
Hamartoma	Random	Solitary	Well-defined	None	Prolonged	Normal	Mostly incidental finding; tuberous sclerosis, Wiskott-Aldrich-like syndrome
Haemangioma	Random	Solitary	Well-/ill-defined	None	Centripetal	Normal	Mostly incidental finding; Beckwith-Wiedemann, Klippel-Trenauney-Weber, Turner syndrome
Haemangioma	Random	Multiple	Well-/ill-defined	None	Centripetal	Normal
Lymphangioma	Subcapsular	Solitary	Well-defined	Possible	Trabeculae	Normal	Incidental finding in child, young adult
Lymphangioma	Subcapsular	Multiple	Well-defined	Possible	Trabeculae	Normal	Incidental finding in child, young adult
Sarcoidosis	Random	Multiple	Ill-defined	Possible	Yes	Enlarged	Sarcoidosis
Peliosis	Random	Multiple	Ill-defined	Yes	Similar to haemangioma	Enlarged	Peliosis hepatis
Littoral cell angioma	Random	Multiple	Ill-defined	None	Prolonged	Normal	Colorectal carcinoma, renal cell carcinoma, hepatocellular carcinoma, lung cancer, lymphoma, pancreatic carcinoma
Lymphoma	Random	Solitary	Ill-defined	Yes	Mild	Enlarged	Associated lymphadenopathy; mostly patients with clinically known lymphoma
Lymphoma	Random	Multiple	Ill-defined	Yes	Mild	Enlarged
Metastases	Random	Solitary	Ill-defined	Possible	Yes	Normal	Breast, lung, ovarian, colorectal and gastric carcinomas; skin melanoma
Metastases	Random	Multiple	Ill-defined	Possible	Yes	Enlarged
Angiosarcoma	Random	Solitary	Ill-defined	Possible	Yes	Normal	Mostly discovered due to early onset of distant metastases
Angiosarcoma	Random	Multiple	Ill-defined	Possible	Yes	Normal	Mostly discovered due to early onset of distant metastases

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