Unit 11- Benign & Malignant Primary Neoplasms (Elie)

What are the 3 benign primary neoplasms?

• Cavernous Hemangioma

• Hamartoma

• Lymphangioma

What is a Cavernous Hemangioma?

Mass of large blood-filled cystic spaces

Cavernous hemangiomas are most commonly:

Asymptomatic

US appearance of a Cavernous Hemangioma?

• Varied appearance

• Inhomogeneous echogenic mass with multiple, small hypoechoic areas

What is this image showing?

Cavernous Hemangioma

Hamartomas are typically ___________ & made of _______ _______?

• Asymptomatic

• Lymphoid tissue

US appearance of a Hamartoma:

• Solitary or multiple

• Well defined but NOT encapsulated

• Solid & cystic components

• Hyperechoic

What is this image showing?

Hamartoma

What is a Lymphangioma?

• Rare malformation of lymphatics

• Endothelium-lined cystic spaces

  • May involve multiple organ systems

US appearance of a Lymphangioma:

• If cysts are large enough, appear anechoic

• If cysts are multiple & grouped closely together, appear as solid lesion

• Cystic Lymphangioma = Mass with extensive cystic replacement of splenic parenchyma

What are the 2 Malignant Primary Neoplasms?

• Lymphoma

• Hemangiosarcoma

What is the most common malignant involvement of the spleen?

Lymphoma

US appearance of Lymphoma?

• Focal or diffuse lesions

• Typically, HYPOECHOIC

• Splenomegaly may or may not be present

What are the 4 appearances of a Lymphoma?

1) Diffuse (low grade lymphomas & Hodgkin’s)

2) Focal small nodules (low grade lymphomas & Hodgkin’s)

3) Focal large nodules

4) Bulky disease

What is a Hemangiosarcoma?

• A rare, malignant, vascular endothelium mass

US appearance of a Hemangiosarcoma:

• Mixed cystic appearance

• Resembles cavernous hemangioma

• May be hyperechoic

How is Mets spread to the spleen?

Hematogenous through the blood stream from the primary site

Mets is the _____ most common site in the spleen?

10th

Where do mets occur from?

• Breast

• Lung

• Ovary

• Stomach

• Colon

• Kidney

• Prostate

• Melanoma

Mets to the spleen are usually ________

Asymptomatic

US appearance of Mets:

• Well-defined

• Isoechoic, hypoechoic, hyperechoic

• Target or halo lesions

If mets are hypoechoic, what should you suspect it is?

• Melanoma

• Lymphoma

What are these images showing?

Metastases

What should you be careful when evaluating mets?

Be careful in evaluating echogenicity