Pathology

What is the most common splenic abnormality?

Splenomegaly

What is the most common cause of splenomegaly?

Portal HTN with cirrhosis

What is splenomegaly?

Enlarged spleen greater than 13 cm in length

What is the Asher sign?

When upper border of spleen extends across anterior aorta by more than 2 cm

What diseases cause splenomegaly with normal splenic echogenicity?

1. Mononucleosis

2. Portal HTN

3. Early sickle cell

4. Wilson Disease

5. Leukemia

6. Polycythemia

What diseases cause HYPERECHOIC splenomegaly?

1. Leukemia

2. Lymphoma

3. Metastasis

4. Sarcoidosis

5. TB

6. Hematoma

What diseases cause HYPOECHOIC splenomegaly?

1. Leukemia

2. Lymphoma

3. Metastasis

4. Portal HTN

5. Gaucher disease

What diseases cause HETEROGENOUS splenomegaly?

1. Abscesses

2. Metastasis

3. Infarction

4. Hemorrhage

What is sarcoidosis?

Inflammatory disease that causes granuloma formation in spleen

What is mononucleosis?

Infection of spleen associated with Ebstein Barr virus

What are splenic granulomas?

Systemic fungal respiratory disease caused by histoplasmosis or TB

What is the sonographic appearance of splenic granulomas?

Diffuse echogenic foci in spleen

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Splenic granulomas

What is a splenic abscess?

Abscess in spleen associated with endocarditis, septicemia, and trauma

What is the sonographic appearance of a splenic abscess?

1. Complex fluid collection with internal echoes

2. Irregular borders

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Splenic abscess

What is the most common benign tumor of the spleen?

Cystic cavernous hemangioma

What is a cystic cavernous hemangioma?

Benign splenic tumor associated with Kasabach-Merritt Syndrome and Klippel-Trenaunay-Weber syndrome

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Splenic hemangioma

What is a hamartoma?

Benign splenic tumor associated with tuberous sclerosis and Wiskott-Aldrich syndrome

What is Gaucher disease?

Autosomal recessive disorder that causes massive splenomegaly due to hypersplenism

What is the sonographic appearance of Gaucher disease?

1. Massive splenomegaly > 18 cm

2. Hypoechoic nodule formation in spleen

3. Hepatomegaly

What is the most common splenic malignancy?

Lymphoma

What is lymphoma?

Malignant lymphatic tumor involving spleen

What is Hodgkin lymphoma?

Cancer that most commonly occurs in patients aged 15 - 24 and over 60

What is the most common type of lymphoma?

Non-Hodgkin

What is Non-Hodgkin lymphoma?

Cancer that most commonly occurs in patients over 60

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Lymphoma

What is angiosarcoma?

Malignant splenic tumor that is very aggressive

What is the sonographic appearance of angiosarcoma?

1. Heterogenous spleen

2. Splenomegaly

3. Hypervascularity

4. Complex mass with cystic and solid components

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Angiosarcoma

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Splenic metastasis