Spleen Cancer
Spleen cancer is a rare but serious condition that often requires imaging studies for diagnosis and follow up. Spleen cancer more commonly spreads to the spleen from other sites of cancer in the body. It’s rare to see “spleen cancer” on a report as radiologists will usually note a mass which may need further workup. This article discusses how imaging helps detect, diagnose, and manage spleen cancer
What Is Spleen Cancer?
Spleen cancer occurs when abnormal cells grow uncontrollably in the spleen, which is an organ that plays a role in the immune system. While primary spleen cancer (originating in the spleen) is rare, secondary spleen involvement from cancers like lymphoma, leukemia, or metastases is more common. Early detection is important for effective treatment, and imaging plays a role in the diagnostic process.
Why Imaging Is Important in Spleen Cancer
Radiology plays an important role in identifying spleen cancer. It helps detect masses or lesions, and assess blood flow. Imaging tests can also show whether the cancer has spread to nearby organs or lymph nodes.
Common Imaging Modalities for Spleen Cancer
1. Ultrasound for Spleen Cancer
Ultrasound is often the first imaging test performed to evaluate the spleen. This technique uses sound waves to create pictures of the organ. It’s non-invasive, cost-effective, and widely available.
Radiologists may use ultrasound to:
•Detect splenic masses or lesions.
•Measure spleen size (splenomegaly).
•Identify cystic or solid structures within the spleen.
Personal Insight: In my practice, ultrasound is often used as the initial step when spleen abnormalities are suspected. It provides quick results and helps guide further imaging if needed.
2. CT Scans: A Closer Look at the Spleen
Computed tomography (CT) scans provide detailed cross-sectional images of the spleen and surrounding areas. With contrast dye, CT scans can highlight abnormalities such as tumors or enlarged lymph nodes.
CT scans are particularly useful for:
•Identifying the exact location and size of splenic lesions.
•Detecting metastases or secondary cancers.
•Assessing complications like rupture or internal bleeding.
CT imaging is commonly used for staging cancer, as it provides a complete view of the abdomen.
3. MRI: Advanced Imaging for Spleen Cancer
Magnetic resonance imaging (MRI) uses magnets and radio waves to produce high-resolution images of the spleen. It is especially helpful in characterizing lesions, differentiating benign from malignant tumors, and detecting infiltration into nearby tissues.
MRI is favored for its ability to provide clear soft tissue contrast, making it an excellent choice for detailed evaluation of splenic abnormalities.
What Radiologists Look For in Cancer of the Spleen
Radiologists carefully analyze the spleen for specific signs of cancer. These may include:
•Focal Lesions: Abnormal masses or growths within the spleen.
•Splenomegaly: Enlargement of the spleen, which may indicate cancer or other underlying conditions.
•Heterogeneous Texture: Uneven density or texture in the spleen tissue.
•Blood Flow Changes: Altered blood supply patterns, which may be visible on contrast-enhanced imaging.
Radiologists often correlate imaging findings with clinical history and laboratory results for accurate diagnosis.
Biopsy vs. Imaging: When Is a Biopsy Needed?
While imaging provides helpful information, a biopsy may be required for definitive diagnosis. Radiologists use imaging to guide needle biopsies, ensuring precision and safety. A biopsy involves extracting a small tissue sample for microscopic examination, which helps confirm the nature of the lesion.
PET Scans for Metastatic Spleen Cancer
Positron emission tomography (PET) scans are used to evaluate the spread of cancer (metastases). PET imaging detects areas of increased metabolic activity, which is a hallmark of cancer cells. When combined with CT (PET-CT), this modality provides both functional and structural information, making it a powerful tool for staging and treatment planning.
How Imaging Guides Treatment Decisions
Imaging studies can guide treatment. For instance:
•Localized Lesions: Surgery, such as splenectomy, may be recommended.
•Widespread Disease: Imaging helps plan systemic treatments like chemotherapy or radiation.
•Follow-Up Scans: Radiologists use imaging to monitor response to treatment and detect recurrence.
Challenges in Spleen Imaging
Non-cancerous conditions like infections, trauma, or benign cysts can mimic cancer on imaging studies.
Radiologist Tip: Clinical context matters. For example, in patients with a history of lymphoma, a new splenic lesion is more likely to represent cancer, whereas in otherwise healthy individuals, benign causes are more likely.
Conclusion
Imaging is an important tool for diagnosing, staging, and managing cancer of the spleen. Tests like ultrasound and CT provide important information that helps guide treatment. If you have concerns about splenic cancer, make sure to work closely with your doctor for the best care.
References:
1.https://my.clevelandclinic.org/health/diseases/spleen-cancer
2.https://pmc.ncbi.nlm.nih.gov/articles/PMC1665244/