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Radiological features of a symptomatic splenic hamartoma
Authors:S. E. Thompson  E. A. Walsh  B. C. Cramer  C. C. Pushpanathan  P. Hollett  L. Ingram  D. Price
Affiliation:(1) Department of Radiology, Janeway Child Health Centre and Memorial University of Newfoundland, Janeway Place, A1A 1R8 St. John's, NF, Canada;(2) Department of Pathology, Janeway Child Health Centre and Memorial University of Newfoundland, St. John's, NF, Canada;(3) Department of Nuclear Medicine, Health Sciences Centre and Memorial University of Newfoundland, St. John's, NF, Canada;(4) Department of Pediatrics, Janeway Child Health Centre and Memorial University of Newfoundland, St. John's, NF, Canada;(5) Department of Surgery, Janeway Child Health Centre and Memorial University of Newfoundland, St. John's, NF, Canada
Abstract:Symptomatic splenic hamartomas are rare in the pediatric age group, with only four previous reports in the literature. Splenic hamartoma has been reported as a solid homogeneous mass without calcification on CT and ultrasound (US), and only one previous report of the findings on MRI has been published. We report a case of a large symptomatic splenic hamartoma in a 14-year-old girl who presented with splenomegaly, pancytopenia and growth retardation. A solid mass with multiple punctate foci resembling calcifications was seen on US. The mass was heterogeneous and better demarcated on enhanced CT. Radiocolloid scintigraphy demonstrated uptake within the lesion, but less than that of normal spleen. The mass was isointense relative to normal splenic tissue on T1-weighted MRI (0.5 T) and of increased intensity with T2 weighting. At splenectomy, a red pulp hamartoma was identified, which contained nodules of hyalinization and necrosis thought to account for the punctate foci seen on US.
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