CT of congenital and acquired abnormalities of the spleen

Computed tomography (CT) is an excellent imaging modality for demonstrating the size, shape, and position of the spleen, as well as for depicting intrasplenic pathologic features. However, it has limited value in the diagnosis of splenic involvement by lymphoma. Greater accuracy in diagnosing splenic lymphoma may be obtained by demonstrating adenopathy in the splenic hilum or by showing focal splenic defects, in addition to splenomegaly. In discussing the normal anatomy of the spleen, congenital variations (eg, accessory spleen, polysplenia, asplenia, and wandering spleen), and acquired abnormalities such as those resulting from trauma, infection, infarction, cysts, and neoplasms, this article provides evidence that CT is valuable in showing a wide variety of splenic variations and abnormalities while simultaneously allowing evaluation of the remaining intraabdominal structures. The cases presented demonstrate both the value and limitations of CT in the examination of patients with congenital and acquired abnormalities of the spleen.