Phlebolith

Changed by Ashesh Ishwarlal Ranchod, 4 Oct 2023

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Phleboliths are literally "vein stones", and represent calcification within venous structures. They are particularly common in the pelvis, where they may mimic ureteric calculi, and are also encountered frequently in venous malformations. There is an association with Maffucci syndrome.

Radiographic features

Phleboliths appear as focal calcifications, often with radiolucent centres (if present, a helpful sign to distinguish them from urolithiasis). This appearance is attributed to calcification peripherally within the vessel and is frequently seen on abdominal radiographs (66% of phleboliths ²). It can also be seen on CT provided thin sections are obtained (at 5 mm thick slices, radiolucent centres will be inapparent in 99% of phleboliths ²).

History and etymology

The word phlebolith is derived from the Ancient Greek words, φλεψ (phleps) meaning vein, and λιθος (lithos) meaning stone or rock ³.

Differential diagnosis

Two signs are helpful in distinguishing a ureteric calculus from a phlebolith:

comet tail sign: favours a phlebolith
soft tissue rim sign: favours a ureteric calculus

-<p><strong>Phleboliths</strong> are literally "vein stones", and represent calcification within venous structures. They are particularly common in the pelvis, where they may mimic <a href="/articles/ureteric-calculi">ureteric calculi</a>, and are also encountered frequently in <a href="/articles/soft-tissue-venous-malformations">venous malformations</a>. There is an association with <a href="/articles/maffucci-syndrome">Maffucci syndrome</a>. </p><h4>Radiographic features</h4><p>Phleboliths appear as focal calcifications, often with radiolucent centres (if present, a helpful sign to distinguish them from <a href="/articles/urolithiasis">urolithiasis</a>). This appearance is attributed to calcification peripherally within the vessel and is frequently seen on abdominal radiographs (66% of phleboliths <sup>2</sup>). It can also be seen on CT provided thin sections are obtained (at 5 mm thick slices, radiolucent centres will be inapparent in 99% of phleboliths <sup>2</sup>).</p><h4>History and etymology</h4><p>The word phlebolith is derived from the Ancient Greek words, φλεψ (phleps) meaning vein, and λιθος (lithos) meaning stone or rock <sup>3</sup>.</p><h4>Differential diagnosis</h4><p>Two signs are helpful in distinguishing a ureteric calculus from a phlebolith:</p><ol>
~~-<li>~~
~~-<a href="/articles/comet-tail-sign-phleboliths">comet tail sign</a>: favours a phlebolith</li>~~
~~-<li>~~
~~-<a href="/articles/soft-tissue-rim-sign-ureteric-calculus">soft tissue rim sign</a>: favours a ureteric calculus</li>~~
+<p><strong>Phleboliths</strong> are literally "vein stones", and represent calcification within venous structures. They are particularly common in the pelvis, where they may mimic <a href="/articles/ureteric-calculi">ureteric calculi</a>, and are also encountered frequently in <a href="/articles/soft-tissue-venous-malformations">venous malformations</a>. There is an association with <a href="/articles/maffucci-syndrome">Maffucci syndrome</a>. </p><h4>Radiographic features</h4><p>Phleboliths appear as focal calcifications, often with radiolucent centres (if present, a helpful sign to distinguish them from <a href="/articles/urolithiasis">urolithiasis</a>). This appearance is attributed to calcification peripherally within the vessel and is frequently seen on abdominal radiographs (66% of phleboliths <sup>2</sup>). It can also be seen on CT provided thin sections are obtained (at 5 mm thick slices, radiolucent centres will be inapparent in 99% of phleboliths <sup>2</sup>).</p><h4>History and etymology</h4><p>The word phlebolith is derived from the Ancient Greek words, φλεψ (phleps) meaning vein, and λιθος (lithos) meaning stone or rock <sup>3</sup>.</p><h4>Differential diagnosis</h4><p>Two signs are helpful in distinguishing a ureteric calculus from a phlebolith:</p><ol>
+<li>
+<a href="/articles/comet-tail-sign-phleboliths">comet tail sign</a>: favours a phlebolith</li>
+<li>
+<a href="/articles/soft-tissue-rim-sign-ureteric-calculus">soft tissue rim sign</a>: favours a ureteric calculus</li>

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Image 5 MRI (STIR) ( create )

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Case 5: soft tissue hemangioma - foot

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