Pancreatic Pathology Diseases, Ultrasound Findings & Diagnosis

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PANCREAS

Pancreas Pathology

Sonographic Findings

A structured guide to pancreatic sonographic appearances, pathology patterns, complications and related ultrasound findings

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CONTENTS PANCREAS PATHOLOGY

01

MORPHOLOGICAL & CONGENITAL VARIANTS

Pancreatic sonographic pathology and related ultrasound findings

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02

ACUTE PANCREATITIS AND EARLY CHANGES

Pancreatic sonographic pathology and related ultrasound findings

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03

COMPLICATIONS OF ACUTE PANCREATITIS

Pancreatic sonographic pathology and related ultrasound findings

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04

CHRONIC PANCREATITIS AND LATE CHANGES

Pancreatic sonographic pathology and related ultrasound findings

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05

PANCREATIC DUCTAL AND OBSTRUCTIVE

Pancreatic sonographic pathology and related ultrasound findings

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PANCREATIC CYSTIC LESIONS

Pancreatic sonographic pathology and related ultrasound findings

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EXOCRINE PANCREATIC TUMORS

Pancreatic sonographic pathology and related ultrasound findings

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08

PANCREATIC NEUROENDOCRINE TUMORS

Pancreatic sonographic pathology and related ultrasound findings

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09

VASCULAR, HEMORRHAGIC AND ISCHEMIC LESIONS

Pancreatic sonographic pathology and related ultrasound findings

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10

INFECTIVE AND INFLAMMATORY CONDITIONS

Pancreatic sonographic pathology and related ultrasound findings

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11

IATROGENIC AND POST-SURGICAL

Pancreatic sonographic pathology and related ultrasound findings

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TRAUMATIC PANCREATIC LESIONS

Pancreatic sonographic pathology and related ultrasound findings

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CONGENITAL AND DEVELOPMENTAL ANOMALIES

Pancreatic sonographic pathology and related ultrasound findings

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SYSTEMIC, METABOLIC AND SECONDARY CONDITIONS

Pancreatic sonographic pathology and related ultrasound findings

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PERIPANCREATIC EXTENSION AND ADJACENT ORGAN INVOLVEMENT

Pancreatic sonographic pathology and related ultrasound findings

15

No matching pancreatic pathology found.

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Spleen Pathology & Imaging Complete Diagnostic Guide

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SPLEEN

Spleen
Pathology

Sonographic Findings

A structured sonographic pathology index covering splenomegaly, cystic lesions, abscesses, trauma, infarction, vascular lesions, tumors, infiltrative disorders, congenital abnormalities and systemic disease.

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CONTENTS SPLENIC PATHOLOGY

01

SPLENOMEGALY

Diffuse splenic enlargement and major systemic causes

01

Mild to moderate splenomegaly (non-specific) Massive splenomegaly (>20 cm, diffuse disease) Congestive splenomegaly (portal hypertension, CHF) Infective splenomegaly (malaria, typhoid, EBV, HIV) Hematologic splenomegaly (leukemia, lymphoma) Infiltrative splenomegaly (amyloidosis, Gaucher’s) Chronic liver disease–related congestive spleen Tropical splenomegaly syndrome Autoimmune splenomegaly (SLE, rheumatoid) Post-transfusion splenomegaly Post-splenectomy regrowth (splenosis hyperplasia) Hypersplenism with cytopenia Sarcoid splenomegaly Secondary to myelofibrosis Idiopathic splenomegaly (non-specific)

02

SPLENIC CYSTIC LESIONS

Cystic, pseudocystic, parasitic and multicystic splenic abnormalities

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Simple cyst (epithelial, congenital) Post-traumatic pseudocyst (no epithelial lining) Hydatid cyst (Echinococcus granulosus) Multiloculated hydatid cyst (daughter cysts) Calcified cyst (inactive hydatid) Epidermoid cyst (true congenital) Parasitic cyst (other parasites, rare) Lymphangioma (multicystic, septated) Hemangiomatous cyst Pancreatic pseudocyst extension into spleen Abscess with liquefaction (pseudocyst appearance) Post-infarct cystic degeneration Cystic metastasis (ovary, melanoma, rare) Post-hematoma cystic evolution Post-splenectomy fluid collection (residual cavity) Congenital dermoid cyst (rare) Cystic hamartoma Cystic necrosis in lymphoma Subcapsular cystic lesion (hematoma sequela) Echinococcal rupture with peritoneal spill

03

SPLENIC ABSCESSES & INFECTIVE LESIONS

Pyogenic, fungal, tuberculous, parasitic and septic splenic infection

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Pyogenic abscess (echogenic debris, gas echoes) Multiple small microabscesses (bacterial/fungal) Tuberculous abscess (hypoechoic, necrotic nodes) Fungal abscess (Candida “bull’s-eye” lesions) Typhoid abscess Brucella abscess (rare, multiple small lesions) Parasitic abscess (amoebic / hydatid rupture) Septic embolic abscess (endocarditis source) Post-traumatic infected hematoma Post-splenectomy stump abscess Post-surgery collection (localized) HIV-related microabscesses (Mycobacterium avium) Melioidosis abscess (multiple, target sign) Salmonella splenic abscess Tubercular granulomas (hypoechoic nodules) Syphilitic gummatous lesions (rare) Typhus-related abscess (rare) Actinomycotic abscess Septic pylephlebitis with secondary abscess Fungal granuloma with calcifications Post-sepsis splenic microabscesses Cryptococcal abscess (immunosuppressed) Post-catheter-related seeding abscess Splenic abscess secondary to pancreatitis Post-endocarditis septic emboli

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SPLENIC TRAUMA

Traumatic injury, hematoma, laceration, rupture and post-traumatic complications

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Subcapsular hematoma Intraparenchymal hematoma Splenic rupture (capsular breach, free fluid) Splenic laceration (linear hypoechoic defect) Splenic fracture (fragmented parenchyma) Active bleeding (Doppler jet into peritoneum) Pseudoaneurysm (post-trauma vascular lesion) Post-traumatic abscess Post-traumatic infarction Post-trauma pseudocyst formation Post-embolization infarct Delayed rupture (capsule disruption later) Perisplenic fluid (localized hemoperitoneum) Hemoperitoneum from splenic rupture Post-procedure puncture injury Iatrogenic trauma (biopsy-related) Post-drain catheter tract injury Rib fracture–related splenic laceration Blunt trauma partial tear Post-traumatic scarring / fibrosis

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SPLENIC INFARCTION & ISCHEMIA

Focal and diffuse splenic ischemia, vascular occlusion and infarction

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Segmental infarction (wedge-shaped hypoechoic area) Global splenic infarction (no flow on Doppler) Multiple small infarcts (embolic) Post-traumatic infarction Sickle cell–related infarction Post-embolization infarction Post-surgery ischemic necrosis Vasculitic infarction (SLE, PAN) Portal vein thrombosis with splenic ischemia Splenic artery thrombosis Splenic vein thrombosis (backflow stasis) Splenic torsion (wandering spleen infarct) Transplant-related infarction Post-radiation infarction Post-chemotherapy avascular necrosis

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SPLENIC VASCULAR LESIONS

Benign and malignant vascular tumors, aneurysms and vascular abnormalities

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Hemangioma (most common benign tumor) Cavernous hemangioma (heterogeneous echotexture) Capillary hemangioma (small, echogenic) Hamartoma (isoechoic, increased Doppler flow) Littoral cell angioma (multiple small nodules) Lymphangioma (multicystic lesion) Angiosarcoma (malignant vascular tumor) Hemangiopericytoma Arteriovenous malformation (AVM) Splenic vein aneurysm Splenic artery aneurysm Splenic artery pseudoaneurysm (post-trauma/pancreatitis) Thrombosed aneurysm Peliosis lienis (blood-filled spaces) Splenic varices (portal hypertension) Splenic congestion (venous stasis) Splenic steal phenomenon Post-transplant vascular occlusion Portal hypertensive splenopathy (collaterals) Splenic infarct with reperfusion flow

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SPLENIC TUMORS — BENIGN

Benign solid and vascular splenic masses

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Hemangioma (see vascular section) Hamartoma (splenoma) Lymphangioma Lipoma Fibroma Myelolipoma Leiomyoma Schwannoma Teratoma (rare) Hemangiopericytoma (benign type) Granulomatous pseudotumor (TB/sarcoid) Focal nodular hyperplasia (ectopic type) Inflammatory pseudotumor Calcified benign nodule (old granuloma) Splenic regenerative nodule (post-infarct)

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SPLENIC TUMORS — MALIGNANT

Primary and secondary malignant splenic involvement

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Primary lymphoma (focal/multifocal/diffuse) Secondary lymphoma (most common malignant) Splenic metastasis (melanoma, lung, breast, ovary, colon) Angiosarcoma (primary malignant vascular tumor) Hemangioendothelioma (intermediate malignant) Malignant fibrous histiocytoma Fibrosarcoma Leiomyosarcoma Osteogenic sarcoma metastasis Adenocarcinoma metastasis Choriocarcinoma metastasis Carcinoid metastasis Melanoma metastasis (commonest) Post-chemotherapy recurrent lymphoma Splenic leukemia infiltration (CML/CLL) Histiocytic sarcoma Kaposi sarcoma (HIV-related) Myeloid sarcoma (chloroma) Malignant lymphoma with necrotic center Multiple metastatic nodules (cannonball pattern) Secondary invasion from left kidney/adrenal/pancreas Splenic plasmacytoma Post-radiation sarcoma Metastatic carcinosarcoma Splenic carcinoma-like mass (rare)

09

INFILTRATIVE, STORAGE & SYSTEMIC

Storage diseases, hematologic infiltration and systemic splenic involvement

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Amyloidosis (increased echogenicity, granular) Gaucher’s disease (coarse echotexture, splenomegaly) Niemann–Pick disease (hyperechoic) Myelofibrosis (massive spleen, inhomogeneous) Leukemic infiltration (diffuse hypo- or hyperechoic) Lymphoproliferative disorder (homogeneous enlargement) Sarcoidosis (multiple hypoechoic nodules) Histiocytosis X Extramedullary hematopoiesis (hypoechoic foci) Metabolic storage disorder (glycogen / lipid) Amyloid nodules with calcifications Post-chemotherapy fibrotic replacement Storage disease–related infarction Post-bone marrow transplant infiltration Sickle cell disease (autosplenectomy phase) Portal hypertension–related congestion Mononucleosis (diffuse enlargement) AIDS-related splenic disease Splenic peliosis (blood-filled cavities) Splenic hemosiderosis (increased echogenicity)

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POST-SURGICAL & IATROGENIC

Postoperative, post-procedural and treatment-related splenic findings

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Post-splenectomy residual splenic tissue (splenosis) Post-splenectomy abscess at bed Post-embolization infarct Post-biopsy hematoma Post-drain infection Post-transplant vascular occlusion Post-surgical seroma Post-trauma residual cavity Post-radiofrequency ablation scar Post-chemotherapy atrophic spleen

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CONGENITAL & DEVELOPMENTAL

Congenital absence, accessory tissue, anatomical variants and developmental abnormalities

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Accessory spleen (splenunculus) Polysplenia (multiple small spleens) Asplenia (congenital absence) Splenic cleft (notch variant) Wandering spleen (long pedicle) Ectopic spleen (pelvic, thoracic) Congenital cyst Congenital splenic hypoplasia Double spleen (bilobed) Situs anomalies (asplenia/polysplenia syndromes)

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SYSTEMIC & SECONDARY

Splenic manifestations secondary to systemic, vascular, infectious and inflammatory disease

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Portal hypertension (congestive splenomegaly) Cirrhosis-related hypersplenism CHF causing splenic congestion Renal failure–related splenic edema Endocarditis (embolic abscesses) Sepsis (microabscesses) SLE (vasculitic infarcts) PAN (multiple infarcts) Amyloidosis (granular echotexture) Sarcoidosis (nodular hypoechoic foci) Malaria (diffuse enlargement, coarse texture) Kala-azar (visceral leishmaniasis) HIV-related splenomegaly Hematologic malignancy (diffuse infiltration) Portal pyaemia with infarcts

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RARE & MISCELLANEOUS

Unusual splenic conditions and uncommon sonographic findings

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Peliosis lienis (blood-filled cavities) Splenic torsion (wandering spleen twisted pedicle) Splenic abscess from pancreatic tail fistula Splenic metastasis from thyroid (reported) Splenic rupture during pregnancy (pathologic) Drug-induced hypersplenism (phenytoin, etc.) Splenic calcification (old granuloma, healed abscess) Splenic cyst with daughter cyst (ruptured hydatid) Splenic involvement in sickle crisis (acute sequestration) Post-infective splenic fibrosis

No matching spleen / splenic pathology found.

Generates a clean text index of the visible spleen pathology chapters and findings.

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