GI Radiology > Spleen > Neoplastic > Lymphoma

Lymphoma

    Lymphomas is the most common malignant tumor of the spleen. Typically, lymphatic drainage to the spleen serves as the primary mechanism by which extranodal lymphomas of varying types disseminate to the spleen. Of the two broad types of lymphoma (B vs. T cell), B cell lymphomas Hodgkin's and non-Hodgkin's disease are often diagnosed from splenic imaging. Primary splenic lymphoma (PSL) is a rare malignancy with a reported incidence of less than 1% of all lymphomas.

Clinical Data: 31 yo female c/o night sweats, swelling in left neck.

    As demonstrated in the selected axial CT slices, the spleen appears enlarged, lobulated and contains multiple areas of low density. The differential to consider in this case would include metastatic disease (malignant melanoma, lung, breast, ovary, prostate, gastric), splenic infarction, Gamna-Gandy bodies (siderotic nodules seen in hemosiderosis & hemochromatosis), hemangioma, angiosarcoma, AIDS associated lymphoma, Kaposi Sarcoma, lymphoma.

    Dx: Hodgkin's lymphoma, nodular sclerosing type. Hodgkin's accounts for 20 - 40% of all lymphomas. Interestingly, CT is only 65% sensitive in demonstrating splenic involvement, a percentage that correlates well with the fact that Hodgkins often appears normal on many imaging studies.

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