Sixty-three patients with splenic cysts, multiple in 7 cases, were rev
iewed, Only 3 patients had a history of previous abdominal trauma. The
cysts ranged in size from less than 1 cm to 15 cm. They were anechoic
in 40 patients, hypoechoic in 16, isoechoic in 4, mixed in one, and i
n 2 cases the echogenicity could not be assessed due to thick marginal
calcifications. The echogenic cysts were larger than the anechoic one
s and frequently calcified, and the findings at surgery, fine-needle a
spiration biopsy and follow-up suggested the echogenicity to be relate
d to a fresh or previous episode of intracystic hemorrhage. Initially,
surgical treatment was undertaken on 10 patients, electively in 9 cas
es and due to cyst rupture in one. At follow-up (n = 37), the size of
the cyst had increased markedly over several years in only 2 patients,
necessitating delayed surgery in one. Routine follow-up of asymptomat
ic splenic cysts was of no clinical value.