1. Normal spleen

3. Splenic variant Ectopic position of the spleen:- Left flank Pelvis
Posterior to the left kidney

4. Splenic variant Splenunculi( accessory spleen )
Small ectopic nodule of splenic tissue usually situated near the hilum of the spleen.
Recieves its blood supply from splenic artery
Sonogrphically
Appears as well defined oval or rounded exceed 4 cm in diameter
Has a normal splenic acoustic characteristics
Not visible on ultrasound unless splenomegaly is present
A splenunculus may enlarge in post splenectomy patients

5. Pathology of the spleen

6. Splenomegally
Enlargement of the spleen is a highly non specific sign associatede with numerous conditions as
Infection due to rubella
Portal hypertension ,
Neoplastic conditions as lymphoma
The aetiology of splenomegaly can not be usually detected on ultrasound

7. Splenomegally
Enlargment of the spleen is considered when its long axis exceeds 12 cm
The spleen enlarges downwards and medially
Its inferior margin becomes rounded and may extend below the left kidney.

8. Benign splenic conditions

9. Splenic cysts Types of splenic cysts Simple cysts
Post traumatic cysts ( liquefied haematoma )
Hydatid cyst
Cystic metastasis

10. Haemangioma
Rare in the spleen
Usually well defined hyperechoic focal lesion , rarely contain cystic areas

11. Splenic abscess Causes :- Uncommon Amoebic or fungal infection
Blood born bacterial infection
Post traumatic

12. Splenic abscess Clinical presentation:- upper abdominal pain and fever
Ultrasound appearance :-
Similar to liver abscess

13. Splenic calcification
Calcifications may occur in old inactive abscess cavities
Associated with traumatic injury
In old resolving post traumatic haematoma

14. Splenic trauma
Splenic laceration is not usually detect by US especially in the immediate post- trauma phase
The laceration appears sonographically as hyperechoic line within the spleen
A frank area of haemorrhag may be detected

15. Splenic trauma

16. Malignant splenic diseases

17. Lymphoma Clinical features :- Anaemia General fatigue Weight loss
The most common malignant disease affecting the spleen
Clinical features :-
Anaemia
General fatigue
Weight loss
Fever
Sweating
Infection and decressed immunity

18. Lymphoma Ultrasound appearance :-
In many cases there is no sonographic abnormalities
Diffuse splenic enlargement with normal , hypo- or hyperechogenicity
Single or multiple and of varying sizes hypoechoic , anechoic , hyperechoic or mixed echogenicity
Lymphadenopathy may be seen elsewhere in the abdomen

19. Metastases Sonographic appearance :-
Metastases occurs in the spleen much less commonly than in the liver
Sonographic appearance :-
As in the liver

20. Thank you