SONOACADEMY - ABDOMINAL ULTRASOUND
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.
SEARCH SPLEEN PATHOLOGY
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
02
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
03
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
04
SPLENIC TRAUMA
Traumatic injury, hematoma, laceration, rupture and post-traumatic complications
04
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
05
SPLENIC INFARCTION & ISCHEMIA
Focal and diffuse splenic ischemia, vascular occlusion and infarction
05
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
06
SPLENIC VASCULAR LESIONS
Benign and malignant vascular tumors, aneurysms and vascular abnormalities
06
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
07
SPLENIC TUMORS — BENIGN
Benign solid and vascular splenic masses
07
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)
08
SPLENIC TUMORS — MALIGNANT
Primary and secondary malignant splenic involvement
08
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
09
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)
10
POST-SURGICAL & IATROGENIC
Postoperative, post-procedural and treatment-related splenic findings
10
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
11
CONGENITAL & DEVELOPMENTAL
Congenital absence, accessory tissue, anatomical variants and developmental abnormalities
11
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)
12
SYSTEMIC & SECONDARY
Splenic manifestations secondary to systemic, vascular, infectious and inflammatory disease
12
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
13
RARE & MISCELLANEOUS
Unusual splenic conditions and uncommon sonographic findings
13
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.
No comments:
Post a Comment