Splenic haemangiomatosis

Last revised by Daniel J Bell on 24 Jun 2021

Splenic haemangiomatosis involves multiple, diffuse splenic hemangiomas replacing its entire parenchyma and is very rare.

Reported associations include

It can occur as a manifestation of systemic angiomatosis or, less commonly, confined to the spleen (diffuse isolated splenic haemangiomatosis). There is total or subtotal replacement of the splenic parenchyma by a vascular proliferation featuring the usual morphological findings of hemangiomas.

Patients may clinically present with 

Non-sensitive and non-specific but may show

  • calcifications in left hypochondriac region
  • features of splenomegaly

May show

  • solid hyperechoic masses
  • complex echogenic mass with cystic areas
  • splenomegaly
  • non-contrast - well defined iso-hypodense masses
  • postcontrast - lesions show homogenous enhancement

Signal characteristics of individual lesions include

Typical uncomplicated lesions

  • T1: most are hypo-isointense while some are hyperintense
  • T2: hyperintense

There is variable intensity if there is associated thrombosis, infarction and/or hemorrhage.

In general, diffuse splenic hemangiomatosis is a benign entity and has an asymptomatic course. It may however present with associated complications (see above).

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