Splenic cystic lymphangioma with atypical ultrasound findings

Splenic lymphangiomas are rare benign tumors occurring more frequently in children. Because of their asymptomatic growth, splenic lymphangiomas are usually suspected based on incidental findings, the diagnosis relying on different imaging techniques and requiring histological confirmation. The rarity of the disease and its atypical imaging findings make the diagnosis of splenic lymphangiomas challenging. We describe the case of an isolated splenic cystic lymphangioma affecting an elderly female patient. The patient was asymptomatic and the blood tests were normal. The tumor appeared on gray-scale ultrasound as an inhomogeneous, mostly hyperechoic septated mass, which is atypical for a cystic lymphangioma. Contrast-enhanced ultrasound and contrast-enhanced computed tomography suggested the benign nature of the tumor and narrowed the diagnosis. The tumor received histopathological confirmation after splenectomy. Various CT and MRI findings in splenic lymphangiomas have been described, but very few reports regarding CEUS exist to this point.