Cystic lesions of the spleen are being noticed with increased frequency as “incidentalomas” during imaging work-up for unrelated causes. As a group, these lesions encompass pure cystic and mixed cystic and solid, benign and malignant processes that in general require a tissue sample for definitive diagnosis. In this review, we will describe the differential diagnosis of cystic lesions of the spleen, highlighting key imaging, clinical and pathologic findings.
IngleSBHingeCRJatalSN. An interesting case of primary epithelial cyst of spleen. Indian J Pathol Microbiol. 2013;56(2):181‐182.
2.
UrrutiaMMergoPJRosLJTorresGMRosPR. Cystic masses of the spleen: radiologic-pathologic correlation. Radiographics. 1996;16(1):107‐129.
3.
BurrigKF. Epithelial (true) splenic cysts. Am J Surg Pathol. 1988;12(4):275‐281.
4.
WilliamsRJGlazerG. Splenic cysts: changes in diagnosis, treatment and etiological concepts. Ann R Coll Surg Engl. 1993;75(2):87‐89.
5.
KundalVKGajdharMKundalRSharmaCAgrawalDMeenaA. Giant epithelial non-parasitic splenic cyst. J Case Rep. 2013;3(1):106‐109.
6.
HardingHE. A large inclusion cyst in a spleen. J Path. 1933;36(3):485.
7.
TouloukianRJMaharajAGhoussoubRReyesM. Partial decapsulation of splenic epithelial cysts: studies on etiology and outcome. J Pediatr Surg. 1997;32(2):272‐274.
8.
SolomouEGPatriarheasGVMpadraFAKaramouzisMVDimopoulosI. Asymptomatic adult cystic lymphangioma of the spleen: case report and review of the literature. Magn Reson Imaging. 2003;21(1):81‐84.
9.
CalligarisLBortulM. Laparoscopic treatment or a nonparasitic splenic cyst: case report. J Laparoendosc Surg. 1996;6(6):431‐434.
10.
TrompetasVPanagopoulosEPriovolou-PapaevangelouMRamantanisG. Giant benign true cyst of the spleen with high serum level of CA 19-9. Eur J Gastroenterol Hepatol. 2002;14(1):85‐88.
11.
ManojMGMisraPKakkarS. Multilocular epithelial cyst of spleen: a rare occurrence. Indian J Pathol Microbiol. 2012;55(4):602‐604.
12.
WuHMKortbeekJB. Management of splenic pseudocysts following trauma: a retrospective case series. Am J Surg. 2006;191(5):631‐634.
13.
LankischPG. The spleen in inflammatory pancreatic disease. Gastroenterology. 1990;98(2):509‐516.
14.
MalkaDHammelPLévyP, et al.Splenic complications in chronic pancreatitis: prevalence and risk factors in a medical-surgical series of 500 patients. Br J Surg. 1998;85(12):1645‐1649.
15.
DahalSDahalSGhimireDKUr RahmanE. Sharma E: sickle cell beta-plus thalassemia with subcapsular hematoma of the spleen. Case Rep Hematol. 2017;2017:3819457.
16.
RicciZJOhSKChernyakV, et al.Improving diagnosis of atraumatic splenic lesions. Part I. Nonneoplastic Lesions. Clin Imaging. 2016;40(4):769‐779.
17.
JarochMTBroughanTAHermannRE. The natural history of splenic infarction. Surgery. 1986;100(4):743‐750.
18.
NoresMPhillipsEHMorgensternL, et al.The clinical spectrum of splenic infarction. Am Surg. 1998;64(2):182‐188.
19.
YoshikaiMKamachiMKobayashiKMurayamaJKamoharaKMinematsuN. Splenic abscess associated with active infective endocarditis. Jpn J Thorac Cardiovac Surg. 2002;50(11):478‐480.
20.
GreenBT. Splenic abscess: report of six cases and review of the literature. Am Surg. 2001;67(1):80‐85.
KazaRZaraSAl-HawaryMMFrancisIR. Primary and secondary neoplasms of the spleen. Cancer Imaging. 2010;10(1):173‐182.
30.
PalasJMatosARamalhoM. The spleen revisited: an overview on magnetic resonance imaging. Radiol Res Practice. 2013;2013:219297.
31.
VanhoenackerFMde BeeckBPDe SchepperAMSalgadoRSnoeckxAParizelPM. Vascular disease of the spleen. Semin Ultrasound CT MR. 2007;28(1):35‐51.
32.
JindalRSullivanRRoddaB, et al.Splenic malformation in a patient with Klippel-Trenaunay syndrome: a case report. J Vasc Surg. 2006;43(4):848‐850.
33.
VahidnezhadHYoussefianLUittoJ. Klippel-Trenaunay syndrome belongs to the PIK3CA-related overgrowth spectrum (PROS). Exp Dermatol. 2016;25(1):17‐19.
34.
CremaEEtchebehereRMGonzagaMNLimaRSBertulucciPAda SilvaAA. Splenic lymphangioma: a rare benign tumor of the spleen treated by laparoscopic surgery. Arq Bras Cir Dig. 2012;25(3):178‐179.
35.
HiattJRPhillipsEHMorgaensternL, eds. Surgical Diseases of the Spleen. Springer Berlin Heidelberg; 1997, p. 15.
36.
YuHMaoQZhouLLiJXuX. Rare case of cystic lymphangioma transforming into lymphangiosarcoma: a case report. Front Oncol. 2022;12:814023.
37.
FeigenbergZWysenbeekAAvidorE. Malignant lymphangioma of the spleen. Isr H Med Scho. 1983;19(2):202‐204.
38.
Al-ShaikhS.MubarakHarbZ. Case report: splenic lymphangioma in an adult. Saudi Med. J. 2017;38(11):1148‐1152.
39.
MakrinVAvitalSWhiteISagieBSzoldA. Laparoscopic splenectomy for solitary splenic tumors. Surg Endosc. 2008;22(9):2009‐2012.
40.
SilvermanMLLiVolsiVA. Splenic hamartoma. Am J Clin Pathol. 1978;70(2):224‐229.
41.
MorgensternLMcCaffertyLRosenbergJMichelSL. Hamartomas of the spleen. Arch Surg. 1984;119(11):1291‐1293.
42.
DardenJWTeeslinkRParrishA. Hamartoma of the spleen: a manifestation of tuberous sclerosis. Am Surg. 1975;41(9):564‐566.
43.
HuffDSLischnerHWGoHC, et al.Unusual tumors in two boys with Wiskott-Aldrich-like syndrome. Lab Invest. 1979;40(2):305‐306.
44.
LamKYYipKHPehWC. Splenic vascular lesions: unusual features and a review of the literature. Aust N Z J Surg. 1999;69(6):422‐425.
45.
SteinbergJJSuhrlandMValensiQ. The spleen in the spleen syndrome: the association of splenoma with hematopoietic and neoplastic disease— compendium of cases since 1864. J Surg Oncol. 1991;47(3):193‐202.
46.
ZissinRLishnerMRathausV. Case report: un- usual presentation of splenic hamartoma; com- puted tomography and ultrasonic findings. Clin Radiol. 1992;45(6):410‐411.
47.
BrinkleyAALeeJK. Cystic hamartoma of the spleen CT and sonographic findings. J Clin Ultrasound. 1981;9(3):136‐138.
48.
WangYJLiFCaoFSunJBLiuJFWangYH. Littoral cell angioma of the spleen. Asian J Surg. 2009;32(3):167‐171.
49.
TsokosMErbersdoblerA. Pathology of peliosis. Forensic Sci Int. 2005;149(1):25‐33.
50.
WarnkeRWeissLMChanJKClearlyMLDorfmanRF. Tumors of the lymph nodes and spleen. Armed Forces Institute of Pathology; 1995.
51.
TadaTWakabayashiTKishimotoH. Peliosis of the spleen. Am J Clin Pathol. 1983;79(6):708‐713.
AhmannDLKielyJMHarrisonEGJrPayneWS. Malignant lymphoma of the spleen. A review of 49 cases in which the diagnosis was made at splenectomy. Cancer. 1966. 19(4): 461‐469.
SordilloEMSordilloPPHajduSI. Primary hemangiosarcoma of the spleen: report of four cases. Med Pediatr Oncol. 1981;9(4):319‐324.
56.
FalkSKrishnanJMeisJM. Primary angiosarcoma of the spleen. A clinicopathologic study of 40 cases. Am J Surg Pathol. 1993;17(10):959‐970.
57.
McGinleyKGoogePHannaWBellJ. Primary angiosarcoma of the spleen: a case report and review of the literature. South Med J. 1995;88(8):873‐875.
58.
SmithVCEisenbergBLMcDonaldEC. Primary splenic angiosarcoma. Case report and literature review. Cancer1985; 55(7):1625‐1627.
59.
ChenKBollesCGGilbertEF. Angiosarcoma of the spleen: a report of two cases and review of the literature. Arch Pathol Lab Med. 1979;103(3):122‐124.
60.
NakaNOhsawaMTomitaY, et al.Prognostic factors in angiosarcoma: a multivariate analysis of 55 cases. J Surg Oncol. 1996;61(3):170‐176.
61.
HsuJTChengHMLinCY, et al.Primary angiosarcioma of the spleen. J Surg Oncol. 2005;92(4):312‐316.
62.
SmithCE. Rusk GY: endothelioma of the spleen. A study of two cases, with review of the literature of primary malignancy of the spleen. Arch Surg. 1923;7(2):371‐414.
63.
AltBHafezGRTriggMShahidiNTGilbertEF. Angiosarcoma of the liver and spleen in an infant. Pediatr Pathol1985; 4(3-4): 331‐339.
64.
GarlockJH. Primary angiosarcoma of the spleen. Mt Sinai J Med. 1940;6:319‐321.
65.
FerraraAGhioneR. Primary angiosarcoma of the spleen. Rass Fisiopathol Clin Ter. 1955;27(9):759‐792.
66.
KrenLKaurPGoncharukVN, et al.Primary angiosarcoma of the spleen in a child. Med Pediatr Oncol. 2003;40(6):411‐412.
67.
ChabalkoJJFraumeniJFJr.Blood-vessel neoplasms in children: epidemiologic aspects. Med Pediatr Oncol1975;1(2):135‐141.
68.
WilkinsonHA3rdLucasJCFooteFWJr. Primary splenic angiosarcoma: a case report. Arch Pathol. 1968;85(2):213‐218.
69.
ZwiLJEvansDJWechslerALCatovskyD. Splenic angiosarcoma following chemotherapy for follicular lymphoma. Hum Pathol. 1986;17(5):528‐530.
70.
AutryJRWeitznerS. Hemangiosarcoma of spleen with spontaneous rupture. Cancer. 1975;35(2):534‐539.
71.
HashmiAPodhaetzERichardsML. Laparoscopic resection of an undifferentiated pleomorphic sarcoma. JSLS. 2010;14(3):426‐430.
72.
PiovanelloPViolaVCostaG, et al. Locally advanced leiomyosarcoma of the spleen. A Case Report and Review of the Literature. World J Surg Oncol. 2007;5(1):135.
73.
DaudiaATWalkerSMorganBLloydDM. Leiomyosarcoma of the spleen. Surgery. 2001;130(5):893‐894.
74.
FarahBLMinMCYSionCSShengTC. Primary splenic leiomyosarcoma as an exceptionally rare cause of ruptured splenomegaly – a case report and review of primary splenic sarcomas. Hum Pathol: Case Rep. 2020;22:200452.
75.
SarodeVRDattaBNSavitriKSinghKBhasinD. Kaposi’s sarcoma of spleen with unusual clinical and histological features. Arch.Pathol Lab Med. 1991;115(10):1042‐1044.
NishikawaGMinamiguchiSHataH,et al.Dedifferentiated liposarcoma involving the spleen and splenic hilum: a report of a case with a rare growth pattern. Int Surg. 2015;100(1):128‐132.
78.
FeakinsRMNortonAK. Rhabdomyosarcoma of the spleen. Histopathology. 1996;29(6):577‐589.
79.
NagiMAngDFarrahJGrayD. Ewing’s sarcoma family tumour (EFT) presents as spontaneous splenic rupture. Am Surg. 2019;85(9):E460‐E464.
80.
MorgensternLBelloJMFisherBLVerhamRP. The clinical spectrum of lymphangiomas and lymphangiomatosis of the spleen. Am Surg. 1992;58(1):599‐604.
81.
LamKYTangV. Metastatic tumors to the spleen: a 25-year clinicopathologic study. Arch Pathol Lab Med. 2000;124(4):526‐530.
82.
WarshauerDMMolinaPLWorawattanakulS. The spotted spleen: CT and clinical correlation in a tertiary care center. J Comput Assist Tomogr. 1998;22(5):694‐702.
83.
HirstAEJrBullockWK. Metastatic carcinoma of the spleen. Am J Med Sci. 1952;223(4):414‐417.
