Diagnostic approach to splenic lesions.

Area of Science:

• Radiology
• Abdominal Imaging
• Diagnostic Imaging

Background:

• Splenic lesions are uncommon and frequently discovered incidentally during cross-sectional imaging.
• The majority of splenic lesions exhibit benign characteristics, identifiable through imaging features.
• Invasive evaluation is reserved for splenic lesions with ambiguous or potentially malignant origins.

Purpose of the Study:

• To review the differential diagnoses of splenic lesions.
• To outline imaging characteristics and provide a diagnostic flowchart for splenic lesions.
• To emphasize the role of imaging in diagnosing splenic lesions and minimizing the need for invasive procedures.

Main Methods:

• Review of literature on splenic lesions and their imaging characteristics.
• Utilizing computed tomography (CT) and magnetic resonance imaging (MRI) as primary diagnostic modalities.
• Development of a flowchart to guide the diagnostic approach to splenic lesions.

Main Results:

• A significant number of splenic lesions can be diagnosed based on imaging morphology alone, negating the need for histology.
• CT and MRI are the preferred imaging tools for evaluating splenic lesions.
• Histological workup is indicated only in select cases, particularly for incidental findings with uncertain etiology.

Conclusions:

• Splenic lesions are rare, often benign, and typically found incidentally.
• Imaging characteristics on CT and MRI are crucial for diagnosis.
• Image-guided biopsies are preferred over splenectomy when histological confirmation is necessary.