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E2033. Large Splenic Masses: Key Imaging Findings for Reaching a Diagnosis
Authors
  1. Elliot Fishman; Johns Hopkins Hospital
  2. Linda Chu; Johns Hopkins Hospital
  3. Satomi Kawamoto; Johns Hopkins Hospital
Background
While most splenic lesions (especially incidentally detected lesions) are benign there is often a challenge when a large splenic mass is detected. The range of large splenic masses ranges from benign (cyst) to infectious (abscess) to benign (hamartoma) and malignant tumors (angiosarcoma). In this exhibit we will review many of the key differential diagnosis points that help one differentiate between these various lesions using CT scanning. We will define the role of multiphase imaging as well as 3D post processing in the analysis of these lesions. The role of imaging and its integration with clinical history and presentation will also be addressed. After reviewing this educational exhibit the radiologist will have a better understanding of how to deal with these challenging cases.

Educational Goals / Teaching Points
1. Understand the spectrum of finding in large (5 cm or greater) splenic lesions 2. Understand the key differential imaging findings to make the correct diagnosis in the majority of casees 3. Understand the role of image post processing in the evaluation of splenic lesions 4. Understand some of the pitfalls in the evaluation of primary splenic lesions 5. Understand the limitations of imaging in the diagnosis of splenic lesions

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
1. Understand the CT appearance of a range of splenic masses using dual phase (arterial and venous) acquisition 2. Understand the key imaging findings that help define specific masses ranging from epidermoid cysts to hamartoma to lymphoma and angiosarcoma 3. Understand how 3D mapping with CT angiography can be helpful in the analysis of splenic lesions

Conclusion
A well structured and defined analysis of a splenic lesion can help the radiologist in reaching specific diagnosis in the majority of cases. This exhibit will help the radiologist deal with these difficult cases.