title: Primary lymphoma of the spleen mimicking simple benign cysts: contrast-enhanced ultrasonography and other imaging findings.
abstract: We report on a case of incidentally detected primary splenic lymphoma mimicking simple benign cysts on abdominal ultrasonography. On contrast-enhanced ultrasonography (CEUS), the lesions showed isoenhancement in the arterial phase with progressive washout and marked hypoenhancement in the parenchymal phase. This pattern enabled us to suspect the malignant nature of the disease, thus preventing a dangerous misdiagnosis. Accordingly, further characterization with other imaging studies (computed tomography, magnetic resonance imaging, and positron emission tomography) was pursued based on CEUS and taking into account the patient's clinical picture and medical history. Collectively, imaging data led us to a diagnosis of suspected primary splenic malignancy, most probably lymphoma, which was histologically confirmed on the surgical specimen after splenectomy.
authors.affiliation: Division of Internal Medicine, Department of Internal Medicine, Hospital of Pavullo, AUSL Modena, Via Suore di S.G.B. Cottolengo 5, Pavullo nel Frignano, 41026, Modena, Italy. s.ballestri@ausl.mo.it.
authors.forename: Stefano
authors.initials: S
authors.lastname: Ballestri
authors.affiliation: Division of Internal Medicine, Department of Biomedical, Metabolic and Neural Sciences, NOCSAE, University of Modena and Reggio Emilia and AUSL Modena, Baggiovara, Modena, Italy.
authors.forename: Amedeo
authors.initials: A
authors.lastname: Lonardo
authors.affiliation: Division of Internal Medicine, Department of Biomedical, Metabolic and Neural Sciences, NOCSAE, University of Modena and Reggio Emilia and AUSL Modena, Baggiovara, Modena, Italy.
authors.forename: Dante
authors.initials: D
authors.lastname: Romagnoli
authors.affiliation: Department of Pathology, Azienda Ospedaliero-Universitaria Policlinico of Modena, University of Modena and Reggio Emilia, Modena, Italy.
authors.forename: Luisa
authors.initials: L
authors.lastname: Losi
authors.affiliation: Division of Internal Medicine, Department of Biomedical, Metabolic and Neural Sciences, NOCSAE, University of Modena and Reggio Emilia and AUSL Modena, Baggiovara, Modena, Italy.
authors.forename: Paola
authors.initials: P
authors.lastname: Loria
mesh_terms: D000368:Aged; D003287:Contrast Media; D003560:Cysts / Q000000981:diagnostic imaging* / Q000473:pathology; D003937:Diagnosis, Differential; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008223:Lymphoma / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D008279:Magnetic Resonance Imaging; D049268:Positron-Emission Tomography; D019275:Radiopharmaceuticals; D013154:Spleen / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D013160:Splenic Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography
chemical_list: D003287:Contrast Media; D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18
keywords: Contrast-enhanced ultrasonography; Cysts; Imaging; Primary splenic lymphoma; Ultrasound