Splenic malignant lesions in lymphoma and solid tumors, a comparative study of imaging techniques

Abstract

Splenic involvement guide treatment and affect prognosis in lymphoma and solid tumors. The most common used imaging techniques in detecting splenic involvement are Ultrasound (US) and Computed Tomography (CT). In this study, our aims were to evaluate the imaging findings regarding the spleen, compare splenic lesions according to the diagnosis and evaluate correlations between US and CT according to splenomegaly and lesions. Between May 2008 and April 2011 we identified 72 patients with splenic lesions or splenomegaly on CT or US. However, we exclude 27 patients from the study because of study protocol. Therefore, we enrolled 45 patients with a proven malignancy who had splenic lesions detected with CT. Seventeen patients had a diagnosis of lymphoma, and 28 patients had non-hematological malignancies. The characteristic features of the splenic lesions, detected on CT in patients with a proven malignancy, varied according to the cancer type. Multiple splenic lesions and splenomegaly in lymphoma patients and only solitary lesions in solid tumors were seen on CT (p< 0.001). Lymphoma patients usually had a solid splenic lesion with splenomegaly on US, but no lesion in solid tumors were seen on US (p< 0.05). The US and CT correlation ratio was inferior for solid tumors.US may miss splenic solid tumor metastases. CT is useful for distinguishing splenic lymphoma involvement from solid tumor metastases. CT seems superior to US in detecting splenic solid tumor metastases.