Кисты селезенки


Cystic splenic lesion

80% of all splenic cysts are pseudocysts caused by trauma, infection, infarction. Worldwide 8% are are due to hydatid cysts

A. CONGENITAL = Epidermoid cyst or epithelial cysts have an epithelial lining and are thus true cysts.Usually solitary. fluid may be clear or viscous dependent on whether contents are hemmorhagic, proteinaceous,fat or cholesterol containing.
B. VASCULAR =
1. Splenic laceration / fracture
2. Hematoma
3. Posttraumatic cyst
4. Cystic degeneration of infarct (embolic/local thrombosis)
5. Secondary to V-P shunts. may see close relationship of the shunt and the splenic cyst.
C. INFECTION/INFLAMMATION
1. Pyogenic abscess
Prevalence: 0.1 - 0.7%
Cause: hematogenous spread (75%), infarction (10%), trauma (15%) Those predisposed to infection include : endocarditis, drug abuse, penetrating trauma, neoplasm, sickle cell disease. These are often treated with a percutaneous drainage
2. Granulomatous infection
(a) Mycobacterium tuberculosis
(b) M. avium-intracellulare
3. Pneumocystis carinii infection
4. Parasitic cyst (echinococcus)
5. Pancreatic pseudocyst
D. CYSTIC NEOPLASM
1. Cavernous hemangioma
2. Lymphangiomatosis
3. Necrotic metastasis (ovarian, pancreatic, endometrial, colonic, mammary carcinoma; chondrosarcoma; lymphoma and malignant melanoma in adults)

CT Findings:
- Sharply demarcated ,unilocular round with a thin wall with attenuation similar to water.
- Higher attenuation if hemmorhagic or proteinaceous
- may have calcification
- suspect hydatid if septated and have daughter cysts and if cysts seen in other organs.

References:

Dahnert, Wolfgang. Radiology Review Manual 4th Edition. Williams and Wilkins, 1999
Siegel Marilyn, Pediatric Body CT, Lippincott ,Williams and Wilkins,1999.

Submitted by:
Paras Khandhar, Medical Student, Creighton University Medical Center
Phillip J. Silberberg, M.D, Radiology, Children‘s Hospital, Omaha, NE
Benjamin Silberberg


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