Citation, DOI, disclosures and article data
Citation:
Venkatesh M, Bell D, Di Muzio B, et al. Splenic amyloidosis. Reference article, Radiopaedia.org (Accessed on 25 Mar 2025) https://doi.org/10.53347/rID-25650
Splenic amyloidosis is rare as an isolated entity. Most often it is associated with either systemic amyloidosis or hepatic amyloidosis.
In general, splenic involvement in amyloidosis is rather frequent (5-10% of cases 6,7).
Symptoms include abdominal mass and left upper quadrant pain. But there is no corellation with the size of the spleen 8.
Complications
Plain radiograph
Plain radiography is neither sensitive nor specific but may show splenomegaly.
CT
splenomegaly
calcification is rarely seen 7
non-contrast CT shows ill-defined heterogeneous lesions
post-contrast CT shows heterogeneous enhancement and hypoperfusion of spleen, which is one of the important indicators of systemic amyloidosis
MRI
splenomegaly or not
T2: affected regions may show decreased signal intensity 1,7
-
on CMR
- no correlation with the values on T1 NATIVE map
- really high, diffuse ECV
- on LGE images the spleen has a specific really high gadolinium uptake ("white spleen") 8
Imaging differential considerations include splenic involvement with:
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2. Mainenti PP. RE: imaging features of hepato-splenic amyloidosis at PET/CT. Korean J Radiol. 2012;13 (3): 368. doi:10.3348/kjr.2012.13.3.368 - Free text at pubmed - Pubmed citation
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3. Chan RS, Abdul Aziz YF, Chandran P et-al. Splenic amyloidosis: a rare cause of spontaneous splenic rupture. Singapore Med J. 2012;52 (11): e232-5. Pubmed citation
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4. Ohyama T, Shimokama T, Yoshikawa Y et-al. Splenic amyloidosis: correlations between chemical types of amyloid protein and morphological features. Mod. Pathol. 1990;3 (4): 419-22. Pubmed citation
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5. Mainenti P, D’Agostino L, Soscia E et-al. Abdominal Imaging. 2003;28 (5): . doi:10.1007/s00261-003-0016-z
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6. Renzulli P, Schoepfer A, Mueller E et-al. Atraumatic splenic rupture in amyloidosis. Amyloid. 2009;16 (1): 47-53. doi:10.1080/13506120802676922 - Pubmed citation
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7. Özcan HN, Haliloğlu M, Sökmensüer C, Akata D, Özmen M, Karçaaltıncaba M. Imaging for abdominal involvement in amyloidosis. (2017) Diagnostic and interventional radiology (Ankara, Turkey). 23 (4): 282-285. doi:10.5152/dir.2017.16484 - Pubmed
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8. Lama N, Briasoulis A, Karavasilis E, Stamatelopoulos K, Chasouraki A, Alexopoulou E, Spiliopoulos S, Theodorakakou F, Dimopoulos MA, Kastritis E, Kelekis NL. The utility of splenic imaging parameters in cardiac magnetic resonance for the diagnosis of immunoglobulin light-chain amyloidosis. Insights Imaging. 2022 Mar 26;13(1):55. doi: 10.1186/s13244-022-01194-8. PMID: 35348907; PMCID: PMC8964909.
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