Spleen in haematological malignancies: spectrum of imaging findings

Abstract

ABSTRACT. Imaging morphology and metabolic activity of splenic lesions is of paramount importance in patients with haematological malignancies; it can alter tumour staging, treatment protocols and overall prognosis. CT, MRI and positron emission tomography (PET)/CT have been shown to be powerful tools for the noninvasive assessment of splenic involvement in various haematological malignancies. Since many haematological malignancies and non-neoplastic conditions can involve the spleen and imaging manifestations can overlap, imaging and clinical findings outside of the spleen should be looked for to narrow the differential diagnosis; confirmation can be obtained by pathological findings. Radiologists should be familiar with the cross-sectional imaging patterns of haematological malignancies involving the spleen as well as non-neoplastic splenic findings common in these patients to facilitate their care and follow-up. This pictorial review provides the common and uncommon imaging appearances and complications of various haematological malignancies involving the spleen on CT, MRI and PET/CT, and common pitfalls in diagnosis.

The differential diagnostic role of pet-CT in sarcoidosis and lymphoma

“…Besides of the size which does not correlate with involvement, spleen is affected in one third of all lymphomas [16,17]. In this study, splenic involvement was found to be significantly higher in the lymphoma group compared to the sarcoidosis group (41.2% vs 6.5%, p = 0.001).…”

Primary spleen lymphoma visualized with contrast enhanced ultrasound – Case report

“…The most common one is the homogeneous splenomegaly (without a focal lesion), which indicates diffuse infiltration of the spleen. Splenic lymphoma can also appear on the grey scale as small, focal or miliary nodules (less than 5mm), multiple large nodular lesions and bulky solid masses [1,10]. Focal lesions are most often hypoechoic relative to normal splenic parenchyma (60-70%) [2,7].…”

Staging and Treatment Response Evaluation in Malignant Lymphomas – Czech Lymphoma Study Group Recommendations According to Criteria Revised in 2014 (Lugano Classification)

“…PET/ CT tedy může nahradit histologické vyšetření měru je jednoduché a zdá se být dostačující pro měření splenomegalie. Dvourozměrné či volumometrické měření není třeba provádět [35][36][37]. Jako splenomegalie je dle revidovaných krité-rií z roku 2014 označována slezina mě-řící ve své dlouhé ose > 13 cm [18].…”