Splenic cyst
Updates to Article Attributes
Splenic cysts, although not particularly common, are the most common focal lesion of the spleen. They may be congenital or secondary.
Epidemiology
The incidence is 7.6 per 10,000. Primary splenic cysts (see below) make up 10-25% of all cysts and are most often encountered in children and young adults. Acquired cysts account for 80% of all cysts.
Clinical features
Usually asymptotic and incidentally discovered at imaging. Left upper quadrant pain and tenderness, and splenomegaly can rarely occur.
Pathology
-
Congenitalcongenital epidermoid splenic cysts, or primary splenic cysts, are lined by epithelium (true cyst) and are usually solitary.A-
a genetic defect of mesothelial migration is considered the cause.
At -
at gross pathology, they are usually large with glistening smooth walls.
Wall - wall calcification uncommon (approx. 15%), but wall trabeculations/septations are common (approx. 85%).
-
a genetic defect of mesothelial migration is considered the cause.
-
Secondarysecondary splenic cysts may be due to:- hydatid cyst
- post traumatic: the end stage of splenic haematoma or splenic infarction with resultant liquefactive necrosis and cystic change. At gross pathology they are usually smaller than true cysts and contain debris and wall calcification (50%). Septations are uncommon.
- pyogenic splenic abscesses
- a complication of pancreatitis such as pseudocyst or walled off necrosis adjacent to spleen. Pancreatic pseudocysts extend beneath pancreatic tail to gain entry to the spleen via the splenic hilum and capsule.
Radiographic features
Ultrasound
Usually shows an anechoic to hypoechoic well defined intrasplenic lesion. Internal echoes may be present depending on aetiology. Their margin may be echogenic and they are surrounded by normal splenic tissue.3
CT
Typically shows a hypo attenuating relatively well defined intrasplenic lesion. The wall is thin and has a sharply demarcation to splenic parenchyma. There is no rim or internal enhancement. Wall calcification may be present.
Differential diagnosis
A number of splenic lesions may appear cystic, depending on the modality (for a complete list see cystic lesions of the spleen article). They include:
- congenital (tend to be unilocular in a majority of cases)
- post traumatic 'false' cyst
- infection
- cystic splenic metastases
- intrasplenic pancreatic pseudocyst
Complications
Complications are rare and include haemorrhage, rupture and infection 6-7.
Treatment and prognosis
Small and asymptomatic cysts do not require treatment. Symptomatic cysts are managed surgically.
-<a href="/articles/splenic-epidermoid-cyst">Congenital epidermoid splenic cysts</a>, or primary splenic cysts, are lined by epithelium (true cyst) and are usually solitary. A genetic defect of mesothelial migration is considered the cause. At gross pathology, they are usually large with glistening smooth walls. Wall calcification uncommon (approx. 15%), but wall trabeculations/septations are common (approx. 85%).</li>-<li>Secondary splenic cysts may be due to:<ul>- +<a href="/articles/splenic-epidermoid-cyst">congenital epidermoid splenic cysts</a>, or primary splenic cysts, are lined by epithelium (true cyst) and are usually solitary.<ul>
- +<li>a genetic defect of mesothelial migration is considered the cause.</li>
- +<li>at gross pathology, they are usually large with glistening smooth walls.</li>
- +<li>wall calcification uncommon (approx. 15%), but wall trabeculations/septations are common (approx. 85%).</li>
- +</ul>
- +</li>
- +<li>secondary splenic cysts may be due to:<ul>
-</ul><h4><strong>Radiographic features</strong></h4><h5>Ultrasound</h5><p>Usually shows an anechoic to hypoechoic well defined intrasplenic lesion. Internal echoes may be present depending on aetiology. Their margin may be echogenic and they are surrounded by normal splenic tissue.<sup>3 </sup></p><h5>CT </h5><p>Typically shows a hypo attenuating relatively well defined intrasplenic lesion. The wall is thin and has a sharply demarcation to splenic parenchyma. There is no rim or internal enhancement. Wall calcification may be present.</p><h4>Differential diagnosis</h4><p>A number of splenic lesions may appear cystic, depending on the modality (for a complete list see <a href="/articles/cystic-lesions-of-the-spleen-1">cystic lesions of the spleen</a> article). They include:</p><ul>- +</ul><h4>Radiographic features</h4><h5>Ultrasound</h5><p>Usually shows an anechoic to hypoechoic well defined intrasplenic lesion. Internal echoes may be present depending on aetiology. Their margin may be echogenic and they are surrounded by normal splenic tissue.<sup>3 </sup></p><h5>CT </h5><p>Typically shows a hypo attenuating relatively well defined intrasplenic lesion. The wall is thin and has a sharply demarcation to splenic parenchyma. There is no rim or internal enhancement. Wall calcification may be present.</p><h4>Differential diagnosis</h4><p>A number of splenic lesions may appear cystic, depending on the modality (for a complete list see <a href="/articles/cystic-lesions-of-the-spleen-1">cystic lesions of the spleen</a> article). They include:</p><ul>
Unable to process the form. Check for errors and try again.