Hamartomas are normally an incidental finding at imaging, surgery or autopsy. They can occur in any age group. Symptoms occur from mass effect if they grow large.
Hamartomas are solitary or multiple, round, well-circumscribed, unencapsulated bulging nodules compressing the adjacent normal splenic parenchyma. Focal fibrosis and cystic areas can be seen.
The pathological differential diagnosis includes haemangioma, Littoral cell angioma, lymphagioma, haemangioendothelioma, sclerosing angiomatoid nodular transformation, angiosarcoma. A definite diagnosis can be difficult due to overlap of features, however positivity of CD8 is a key feature that differentiates hamartoma from other vascular lesions of the spleen.
Most splenic hamartomas are hyperechoic solid masses, with or without cystic changes in ultrasonogram, and are hypervascular in both color Doppler ultrasound and angiogram.
On computed tomography, hamartomas appear as isodense or hypodense solid masses and demonstrate heterogeneous contrast enhancement relative to adjacent normal parenchyma.
MRI is the preferable imaging technique for its distinction from hemangiomas.
- T1 - most lesions are isointense
- T2 - most lesions are heterogeneously hyperintense
dynamic enhanced MRI -
- it is typical to show faint heterogeneous enhancement on immediate postcontrast-enhanced images (key features in the differentiation between hamartomas and hemangiomas).
- on delayed postcontrast images, hamartoma enhances in a relatively uniform and intense fashion +/- with central hypovascular areas.
splenic lesions and anomalies
- congenital anomalies
- mass lesions
- infiltrative processes
- other abnormalities
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- 2. Abbott RM, Levy AD, Aguilera NS et-al. From the archives of the AFIP: primary vascular neoplasms of the spleen: radiologic-pathologic correlation. Radiographics. 2004;24 (4): 1137-63. Radiographics (full text) - doi:10.1148/rg.244045006 - Pubmed citation
- 3. Luna A, Ribes R, Caro P et-al. MRI of focal splenic lesions without and with dynamic gadolinium enhancement. AJR Am J Roentgenol. 2006;186 (6): 1533-47. doi:10.2214/AJR.04.1249 - Pubmed citation
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Synonyms & Alternative Spellings
|Synonyms or Alternative Spelling||Include in Listings?|
|Hamartoma of spleen||✗|
|Hamartoma of the spleen||✗|
|Hamartomas of spleen||✗|
|Hamartomas of the spleen||✗|