Nontraumatic focal lesions of the spleen: assessment of imaging and clinical evaluation.
Fifty-nine cases of nontraumatic splenic disease were reviewed to evaluate the roles of clinical findings, computed tomography, ultrasound, and radionuclide scanning in diagnosis and management. Patient groups included lymphoma (30 patients), infarct (11 patients), abscess (9 patients), cyst (5 patients), hemangioma (3 patients), and hamartoma (1 patient). In no case were clinical findings alone sufficient to diagnose a splenic lesion. Clinical and laboratory manifestations were nonspecific in all groups. Moreover, no radiologic study reliably diagnosed splenic lymphoma or leukemia. All other focal splenic lesions were consistently diagnosed noninvasively. Cross-sectional imaging was more useful than radioisotope scanning, and often provided adjunctive diagnosis of extrasplenic pathology. The superior detail, spatial resolution, and sensitivity of computed tomography made it the single most valuable diagnostic modality.
Department of Surgery, Johns Hopkins Medical Institutions, Baltimore, MD 21205.
P L
PL
Caslowitz
J D
JD
Labs
E K
EK
Fishman
S S
SS
Siegelman
D000038:Abscess / Q000175:diagnosis; D005710:Gallium Radioisotopes; D006222:Hamartoma / Q000175:diagnosis; D006391:Hemangioma / Q000175:diagnosis; D006801:Humans; D008223:Lymphoma / Q000175:diagnosis; D012189:Retrospective Studies; D013158:Splenic Diseases / Q000175:diagnosis*; D013159:Splenic Infarction / Q000175:diagnosis; D013160:Splenic Neoplasms / Q000175:diagnosis; D013671:Technetium Tc 99m Sulfur Colloid; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography
D005710:Gallium Radioisotopes; D013671:Technetium Tc 99m Sulfur Colloid