Skip to main content
Top
Published in: Abdominal Radiology 1/2013

01-02-2013

Multi-modality imaging findings of splenic hamartoma: a report of nine cases and review of the literature

Authors: Jian-hua Wang, Xiao-long Ma, Fang-yuan Ren, Chang-jing Zuo, Jian-ming Tian, Zhi-feng Wang, Jian-ming Zheng

Published in: Abdominal Radiology | Issue 1/2013

Login to get access

Abstract

Purpose

To investigate the presentation of splenic hamartomas (SHs) on ultrasonography (US), CT and MRI.

Methods

Nine patients (5 males and 4 females, mean age, 52.8 years) with pathologically proven SHs were included in this study. US, CT and MRI images were analyzed retrospectively, and imaging features were correlated with pathological findings.

Results

SHs appeared solitary lesion (n = 8) and multiple lesions (n = 1) in the present study. (1) In 8 cases of solitary lesion, the lesions appeared as solid nodules or masses with well-defined margins and varying echogenicity (hyperecho = 5, hypoecho = 2, strong echo = 1) on ultrasound. The lesions showed iso-attenuation (n = 3) or slightly hypo-attenuation (n = 4) on unenhanced CT, and calcification were revealed in 3 lesions. MRI showed isointensity (n = 3) or hypointensity (n = 2) on the T1-weighted image, and heterogeneous hypointensity (n = 2), slightly hyperintensity (n = 2) and hyperintensity (n = 1) on the T2-weighted image. The enhanced patterns of SHs showed mild diffuse heterogeneous enhancement (n = 6) and prominent enhancement (n = 1) during arterial phase and above 7 lesions were demonstrated progressive enhancement at delayed phase on enhanced CT. One lesion without any enhancement was revealed in another patient. (2) One case of multiple lesions included 1 cystic lesion with irregular calcification and 7 solid lesions with progressive enhancement on CT images.

Conclusions

Combination of a variety of imaging modalities could more fully reflect the pathological characteristics and contribute to the diagnosis of SH.
Literature
1.
go back to reference Silverman ML, LiVolsi VA (1978) Splenic hamartoma. Am J Clin Pathol 70:224–229PubMed Silverman ML, LiVolsi VA (1978) Splenic hamartoma. Am J Clin Pathol 70:224–229PubMed
2.
go back to reference Lee H, Maeda K (2009) Hamartoma of the spleen. Arch Pathol Lab Med 133:147–151PubMed Lee H, Maeda K (2009) Hamartoma of the spleen. Arch Pathol Lab Med 133:147–151PubMed
3.
go back to reference Abbott RM, Levy AD, Aguilera NS, Gorospe L, Thompson WM (2004) From the archives of the AFIP Primary vascular neoplasms of the spleen: radiologic-pathologic correlation. Radiographics 24:1137–1163PubMedCrossRef Abbott RM, Levy AD, Aguilera NS, Gorospe L, Thompson WM (2004) From the archives of the AFIP Primary vascular neoplasms of the spleen: radiologic-pathologic correlation. Radiographics 24:1137–1163PubMedCrossRef
4.
go back to reference Zissin R, Lishner M, Rathaus V (1992) Case report: unusual presentation of splenic hamartoma; computed tomography and ultrasonic findings. Clin Radiol 45:410–411PubMedCrossRef Zissin R, Lishner M, Rathaus V (1992) Case report: unusual presentation of splenic hamartoma; computed tomography and ultrasonic findings. Clin Radiol 45:410–411PubMedCrossRef
5.
go back to reference Saint-Blancard P, Trueba F (2009) A rare splenic lesion, the splenoma or splenic hamartoma. Rev Med Interne 30:533–536PubMedCrossRef Saint-Blancard P, Trueba F (2009) A rare splenic lesion, the splenoma or splenic hamartoma. Rev Med Interne 30:533–536PubMedCrossRef
6.
go back to reference Fernandez-Canton G, Capelastegui A, Merino A, et al. (1999) Atypical MRI presentation of a small splenic hamartoma. Eur Radiol 9:883–885PubMedCrossRef Fernandez-Canton G, Capelastegui A, Merino A, et al. (1999) Atypical MRI presentation of a small splenic hamartoma. Eur Radiol 9:883–885PubMedCrossRef
7.
go back to reference Tang S, Shimizu T, Kikuchi Y, et al. (2000) Color Doppler sonographic findings in splenic hamartoma. J Clin Ultrasound 28:249–253PubMedCrossRef Tang S, Shimizu T, Kikuchi Y, et al. (2000) Color Doppler sonographic findings in splenic hamartoma. J Clin Ultrasound 28:249–253PubMedCrossRef
8.
go back to reference Ohtomo K, Fukuda H, Mori K, et al. (1992) CT and MR appearances of splenic hamartoma. J Comput Assist Tomogr 16:425–428PubMedCrossRef Ohtomo K, Fukuda H, Mori K, et al. (1992) CT and MR appearances of splenic hamartoma. J Comput Assist Tomogr 16:425–428PubMedCrossRef
9.
go back to reference Thompson SE, Walsh EA, Cramer BC, et al. (1996) Radiological features of a symptomatic splenic hamartoma. Pediatr Radiol 26:657–660PubMedCrossRef Thompson SE, Walsh EA, Cramer BC, et al. (1996) Radiological features of a symptomatic splenic hamartoma. Pediatr Radiol 26:657–660PubMedCrossRef
10.
go back to reference Chevallier P, Guzman E, Fabiani P, et al. (1999) Fibrous splenic hamartoma: imaging features. J Radiol 80:1668–1671PubMed Chevallier P, Guzman E, Fabiani P, et al. (1999) Fibrous splenic hamartoma: imaging features. J Radiol 80:1668–1671PubMed
11.
go back to reference Ramani M, Reinhold C, Semelka RC, et al. (1997) Splenic hemangiomas and hamartomas: MR imaging characteristics of 28 lesions. Radiology 202:166–172PubMed Ramani M, Reinhold C, Semelka RC, et al. (1997) Splenic hemangiomas and hamartomas: MR imaging characteristics of 28 lesions. Radiology 202:166–172PubMed
12.
go back to reference Conlon S, Royston D, Murphy P (2007) Splenic hamartoma. Cytopathology 18:200–202PubMed Conlon S, Royston D, Murphy P (2007) Splenic hamartoma. Cytopathology 18:200–202PubMed
13.
go back to reference Hayes TC, Britton HA, Mewborne EB, et al. (1998) Symptomatic splenic hamartoma: case report and literature review. Pediatrics 101:E10PubMedCrossRef Hayes TC, Britton HA, Mewborne EB, et al. (1998) Symptomatic splenic hamartoma: case report and literature review. Pediatrics 101:E10PubMedCrossRef
14.
go back to reference Iozzo RV, Haas JE, Chard RL (1980) Symptomatic splenic hamartoma: a report of two cases and review of the literature. Pediatrics 66:261–265PubMed Iozzo RV, Haas JE, Chard RL (1980) Symptomatic splenic hamartoma: a report of two cases and review of the literature. Pediatrics 66:261–265PubMed
15.
go back to reference Warnke RA, Weiss LM, Chan JK, Cleary ML, Dorfman RF (1995) Tumors of the lymph nodes and spleen. In: Rosai J, Sobin LH (eds) Atlas of tumor pathology. Washington, DC: Armed Forces Institute of Pathology, pp 3–14 Warnke RA, Weiss LM, Chan JK, Cleary ML, Dorfman RF (1995) Tumors of the lymph nodes and spleen. In: Rosai J, Sobin LH (eds) Atlas of tumor pathology. Washington, DC: Armed Forces Institute of Pathology, pp 3–14
16.
go back to reference Yoshizawa J, Mizuno R, Yoshida T, et al. (1999) Spontaneous rupture of splenic hamartoma: a case report. J Pediatr Surg 34:498–499PubMedCrossRef Yoshizawa J, Mizuno R, Yoshida T, et al. (1999) Spontaneous rupture of splenic hamartoma: a case report. J Pediatr Surg 34:498–499PubMedCrossRef
17.
go back to reference Kassarjian A, Patenaude YG, Bernard C, Bell L (2001) Symptomatic splenic hamartoma with renal, cutaneous, and hematological abnormalities. Pediatr Radiol 31:111–114PubMedCrossRef Kassarjian A, Patenaude YG, Bernard C, Bell L (2001) Symptomatic splenic hamartoma with renal, cutaneous, and hematological abnormalities. Pediatr Radiol 31:111–114PubMedCrossRef
18.
go back to reference Cualing H, Wang G, Noffsinger A, Fenoglio-Preiser C (2001) Heterotopic ovarian splenoma: report of a first case. Arch Pathol Lab Med 125:1483–1485PubMed Cualing H, Wang G, Noffsinger A, Fenoglio-Preiser C (2001) Heterotopic ovarian splenoma: report of a first case. Arch Pathol Lab Med 125:1483–1485PubMed
19.
go back to reference Darden JW, Teeslink R, Parrish A (1975) Hamartoma of the spleen: a manifestation of tuberous sclerosis. Am Surg 41:564–566PubMed Darden JW, Teeslink R, Parrish A (1975) Hamartoma of the spleen: a manifestation of tuberous sclerosis. Am Surg 41:564–566PubMed
20.
go back to reference Huff DS, Lischner HW, Go HC, et al. (1979) Unusual tumors in two boys with Wiskott-Aldrich like syndrome. Lab Invest 40:305–306 Huff DS, Lischner HW, Go HC, et al. (1979) Unusual tumors in two boys with Wiskott-Aldrich like syndrome. Lab Invest 40:305–306
21.
go back to reference Falk S, Stutte HJ (1989) Hamartomas of the spleen: A study of 20 biopsy cases. Histopathology 14:603–612PubMedCrossRef Falk S, Stutte HJ (1989) Hamartomas of the spleen: A study of 20 biopsy cases. Histopathology 14:603–612PubMedCrossRef
22.
go back to reference Wirbel RJ, Uhlig U, Futterer KM (1996) Case report: splenic hamartoma with hematologic disorders. Am J Med Sci 311:243–246PubMedCrossRef Wirbel RJ, Uhlig U, Futterer KM (1996) Case report: splenic hamartoma with hematologic disorders. Am J Med Sci 311:243–246PubMedCrossRef
23.
go back to reference Yu RS, Zhang SZ, Hua JM (2004) Imaging findings of splenic hamartoma. World J Gastroenterol 10:2613–2615PubMed Yu RS, Zhang SZ, Hua JM (2004) Imaging findings of splenic hamartoma. World J Gastroenterol 10:2613–2615PubMed
24.
go back to reference Zukerberg LR, Kaynor BL, Silverman ML, Harris NL (1991) Splenic hamartoma and capillary hemangioma are distinct entities: Immunohistochemical analysis of CD8 expression by endothelial cells. Hum Pathol 22:1258–1261PubMedCrossRef Zukerberg LR, Kaynor BL, Silverman ML, Harris NL (1991) Splenic hamartoma and capillary hemangioma are distinct entities: Immunohistochemical analysis of CD8 expression by endothelial cells. Hum Pathol 22:1258–1261PubMedCrossRef
25.
go back to reference Ali TZ, Beyer G, Taylor M, Volpe C, Papadimitriou JC (2005) Splenic hamartoma: immunohistochemical and ultrastructural profile of two cases. Int J Surg Patho 13:103–111CrossRef Ali TZ, Beyer G, Taylor M, Volpe C, Papadimitriou JC (2005) Splenic hamartoma: immunohistochemical and ultrastructural profile of two cases. Int J Surg Patho 13:103–111CrossRef
26.
go back to reference Goerg C, Schwerk WB (1994) Color Doppler imaging of focal splenic masses. Eur J Radio 18:214–219CrossRef Goerg C, Schwerk WB (1994) Color Doppler imaging of focal splenic masses. Eur J Radio 18:214–219CrossRef
27.
go back to reference Nakanishi S, Shiraki K, Yamamoto K, et al. (2005) Basket pattern blood flow signals discovered in a case of splenic hamartoma by power Doppler ultrasonography. World J Gastroenterol 11:5235–5238PubMed Nakanishi S, Shiraki K, Yamamoto K, et al. (2005) Basket pattern blood flow signals discovered in a case of splenic hamartoma by power Doppler ultrasonography. World J Gastroenterol 11:5235–5238PubMed
28.
go back to reference Brinkley AA, Lee JK (1981) Cystic hamartoma of the spleen: CT and sonographic findings. J Clin Ultrasound 9:136–138PubMedCrossRef Brinkley AA, Lee JK (1981) Cystic hamartoma of the spleen: CT and sonographic findings. J Clin Ultrasound 9:136–138PubMedCrossRef
29.
go back to reference Niizawa M, Ishida H, Morikawa P, Naganuma H, Masamune O (1991) Color Doppler sonography in a case of splenic hemangioma: value of compressing the tumor. AJR Am J Roentgenol 157:965–966PubMed Niizawa M, Ishida H, Morikawa P, Naganuma H, Masamune O (1991) Color Doppler sonography in a case of splenic hemangioma: value of compressing the tumor. AJR Am J Roentgenol 157:965–966PubMed
30.
go back to reference Komaki S, Gombas OF (1976) Angiographic demonstration of a calcified splenic hamartoma. Radiology 121:77–78PubMed Komaki S, Gombas OF (1976) Angiographic demonstration of a calcified splenic hamartoma. Radiology 121:77–78PubMed
31.
go back to reference Norowitz DG, Morehouse HT (1989) Isodense splenic mass: hamartoma, a case report. Comput Med Imaging Graph 13:347–350PubMedCrossRef Norowitz DG, Morehouse HT (1989) Isodense splenic mass: hamartoma, a case report. Comput Med Imaging Graph 13:347–350PubMedCrossRef
32.
33.
go back to reference Shimuzu K, Suga K, Matsunaga N, et al. (1998) Splenic hamartoma presenting as a “hot spot” on Tc-99 m phytate SPECT imaging. Clin Nucl Med 23:370–373PubMedCrossRef Shimuzu K, Suga K, Matsunaga N, et al. (1998) Splenic hamartoma presenting as a “hot spot” on Tc-99 m phytate SPECT imaging. Clin Nucl Med 23:370–373PubMedCrossRef
34.
go back to reference Avila L, Sivaprakasam P, Viero S, et al. (2009) Splenic hamartoma in a child in the era of PET-CT. Pediatr Blood Cancer 53:114–116PubMedCrossRef Avila L, Sivaprakasam P, Viero S, et al. (2009) Splenic hamartoma in a child in the era of PET-CT. Pediatr Blood Cancer 53:114–116PubMedCrossRef
Metadata
Title
Multi-modality imaging findings of splenic hamartoma: a report of nine cases and review of the literature
Authors
Jian-hua Wang
Xiao-long Ma
Fang-yuan Ren
Chang-jing Zuo
Jian-ming Tian
Zhi-feng Wang
Jian-ming Zheng
Publication date
01-02-2013
Publisher
Springer-Verlag
Published in
Abdominal Radiology / Issue 1/2013
Print ISSN: 2366-004X
Electronic ISSN: 2366-0058
DOI
https://doi.org/10.1007/s00261-012-9880-8

Other articles of this Issue 1/2013

Abdominal Radiology 1/2013 Go to the issue
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.