A diagnostic approach to splenic lesions

Spleen histology and imaging features The spleen is an encapsulated organ composed of vascular sinuses, which comprise the red pulp, and interspersed cords of lymphatic tissue, making up the white pulp.2 CT imaging demonstrates heterogeneous splenic enhancement on arterial phase imaging, due to variation in blood flow through the sinuses and cords. Heller et al described a management algorithm based on imaging characteristics, prior imaging studies and clinical history.3 If a splenic lesion with benign imaging characteristics (either a cyst or homogeneous, low-attenuation with no enhancement and smooth margins) is detected in an asymptomatic patient, no follow-up imaging is necessary. [...]hemangioendotheliomas have variable histology and may contain necrosis or hemorrhage.