Splenic amyloidosis

Splenic amyloidosis is rare as an isolated entity. Most often it is associated with either systemic amyloidosis or hepatic amyloidosis.

Epidemiology

In general, splenic involvement in amyloidosis is rather frequent (5-10% of cases ^6,7).

Clinical presentation

Symptoms include abdominal mass and left upper quadrant pain.

Complications

• atraumatic splenic rupture ⁶

Radiographic features

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
• T2: affected regions may show decreased signal intensity ^1,7

Differential diagnosis

Imaging differential considerations include splenic involvement with:

• splenic tumors
• chronic myeloid leukemia
• iron overload