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The spleen is enlarged ( 16.5 cm ). There is a 4.8 cm lesion with mobile echogenic debris and no increased vascularity in the lower aspect of the spleen. Adjacent to this is a smaller 1.7 cm simple cyst.
The liver has normal echotexture and echogenicity with no focal lesion. The gallbladder is normal in appearance with no stones or sludge and no wall thickening. The main portal vein is non-dilated and flow is normal direction. There is no biliary dilatation. The pancreas is normal in appearance. The kidneys are normal in size and appearance.
The larger splenic lesion with uniform internal low level echoes has features of epidermoid cyst and would be atypical for an abscess.