Splenic Pathology: Splenic Lymphangioma

A lymphangioma is a tumor like congenital malformation of the lymphatic system arising from sequestered lymphatic tissue that does not communicate with the normal lymphatic system. This noncommunication results in a water density mass consisting of cystic, lymph endothelium lined spaces. The walls are made of fibrous tissue and smooth muscle. Lymphangiomas are not malignant, however can grow, engulf, and impinge upon adjacent structures. The involvement can be localized to the spleen or be part of a more widespread, multi-system, cystic angiomatosis often affecting the liver, bone, lung and brain.

Lymphangiomas are classified as cavernous, cystic or capillary. Splenic lymphangiomas are typically the cystic type and can be single or multiple. These are often asymptomatic and incidentally discovered. On CT, lymphangiomas are fluid density, thin-walled, well circumscribed and non-enhancing. These lesions tend to be subcapsular, but can occur anywhere in the spleen. Lymphangiomas may be indistinguishable from other cystic lesions in the spleen including splenic cysts, cystic degeneration of infarcts, cystic metastasis and abscesses.