title: [Splenic cysts as an incidental finding--what's next?].
abstract: METHODS
  A 55-year-old woman presented comfortable and well-nourished for a check up. The physical examination remained without pathological results. However lipase parameter in serum was conspicuously elevated we performed an ultrasound examination.
  
  
  RESULTS
  An abdomen sonography revealed besides regular pancreas morphology a hypoechoic lesion of 11 × 10 mm in the liver and multiple hypoechoic inhomgeneous lesions in the spleen. Because of the inhomogeneous results and septa we decided to arrange an abdomen computer tomography (CT) in which the complex of cysts was stated with a size of 59 × 44 mm. As the differential diagnosis of the cysts could be an echinococcosis or amoebic infection we performed a serological analysis at the first appointment and 4 weeks later. Both test results were negative.
  
  
  METHODS
  Eight years later we indicated a magnetic resonance tomography (MRI with MRCP) to exclude a compression of the pancreatic duct by the splenic or liver cysts because the lipase und C-reactive protein (CRP) in serum was rising up again . The MRI scan showed a progression of the splenic cysts complex to 88 × 69 mm and the liver cyst to 25 × 20 mm without signs for compression or a malignant process. A correlation between elevated lipase and splenic cysts was not evident. Despite progression of the splenic cysts we decided in view of the comfortable condition of the patient and negative serological analysis for a conservative proceeding in terms of regular check ups.
  
  
  CONCLUSIONS
  From our point of view also in extended non-parasitic splenic cysts it is reasonable to follow a nonoperative regime as long as clinical complaints, parasitic genesis and malignant process can be excluded.
authors.affiliation: Praxis für Innere Medizin, Berlin.
authors.forename: A
authors.initials: A
authors.lastname: Schott
authors.affiliation: Praxis für Dermatologie und Venerologie, Berlin.
authors.forename: R
authors.initials: R
authors.lastname: Husak
authors.affiliation: Praxis für Innere Medizin, Berlin.
authors.forename: M
authors.initials: M
authors.lastname: Kempf
mesh_terms: D015415:Biomarkers / Q000097:blood; D003560:Cysts / Q000097:blood* / Q000175:diagnosis*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D033162:Incidental Findings; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D018802:Patient-Centered Care / Q000379:methods*; D013158:Splenic Diseases / Q000097:blood* / Q000175:diagnosis*; D014057:Tomography, X-Ray Computed
chemical_list: D015415:Biomarkers