[Echogenic splenic lesions--incidence and differential diagnosis]

In order to estimate the incidence and clinical relevance of echogenic focal lesions in the spleen, 121,372 ultrasound investigations from seven laboratories were evaluated. Ninety-two cases with echogenic lesions in the spleen were reviewed (incidence: 3.2 to 14.2 of 10,000 patients). Differential diagnosis included neoplastic tumors (17.4%; five metastases, three lymphomas, seven hemangiomas, one lymphangiomatosis), vascular disorders (17.4%: bleeding, infarct) and inflammatory focal lesions (8.7%; abscess, calcifications). Follow-up studies showed no change in size and pattern in a further 17.4% of the lesions, indicating benign disorders. Thirty patients suffered from a malignant condition with splenic metastasis or lymphomas in eight cases. In a further five patients, it was possible to confirm echogenic hemangiomas. There are no specific echographic patterns which differentiate hemangiomas from malignant tumors.