Splenic lymphangioma: US and CT diagnosis and clinical manifestations

Background and methods: We tried to determine the role and problems of gray -scale sonography (US), computed tomography (CT), and color Doppler sonogra phy in the diagnosis of splenic lymphangioma on the basis of our experience with seven adult cases with this relatively rare tumor. Results: (1) The w hole spleen was replaced by a collection of cysts of different sizes with o r without calcifications in six patients. In these patients, color Doppler sonography showed the intrasplenic arteries and veins running along the cys t walls. (2) The enlarged spleen occupied the whole upper abdomen and conta ined numerous small cysts in one patient. The patient was initially diagnos ed as having a pancreatic tumor because of the location, but color Doppler sonography clearly demonstrated two vessels (artery and vein) running paral lel from the center of the mass. This characteristic vascular structure led to the determination that the mass was the markedly enlarged spleen. (3) T he splenic lesion was isolated in six patients but was associated with mese nteric and pleural lymphangioma in one symptomatic patient. Conclusions: (1 ) When US shows multiple cysts of different sizes in the spleen, the diagno sis of splenic lymphangioma is not difficult to make with US and CT alone. (2) Color Doppler sonography is a very useful tool to increase diagnostic c onfidence because it demonstrates the vasculature of the mass. (3) When exa mining patients with splenic lymphangioma, one should consider the possibil ity of multiorgan involvement.