Figure Legends
Figure 1
The Heller’s Diagnostic and follow-up strategy. (1) *Cyst: imperceptible
wall, near-water attenuation (<10 HU), no enhancement. †:
Hemangioma: discontinuous, peripheral, centripetal enhancement (findings
that are uncommon in splenic hemangiomas). ‡: Benign imaging features:
homogeneous, low attenuation (<20 HU), no enhancement, smooth
mar- gins. §: Evaluate: PET vs. MRI vs. biopsy. ll: Suspicious imaging
features: heterogeneous, enhancement, irregular margins, necrosis,
splenic parenchymal or vascular invasion, substantial enlargement. ¶:
Indeterminate imaging features: heterogeneous, intermediate attenuation
(>20 HU), enhancement, smooth margins. #: Follow-up MRI in
6 and 12 months.
Figure 2
Contrast-enhanced computed tomography (CT) scans obtained in case 1
Initial visit: (a) arterial phase; (b) delayed phase
Innumerable splenic tumors were seen.
Six months later: (c) arterial phase; (d) delayed phase
The tumors had enlarged.
Figure 3
Laparoscopic image of the tumors in case 1
Innumerable whitish splenic tumors were seen (arrows).
Figure 4
Contrast-enhanced CT scans obtained in case 2
Initial visit: (a) arterial phase; (b) delayed phase
A solitary splenic tumor (maximum diameter: 2.0 cm) was seen.
Twelve months later: (c) arterial phase; (d) delayed phase
The tumor had enlarged (maximum diameter: 2.5 cm).
Figure 5
Laparoscopic image of the tumor in case 2
A solitary, slightly hard tumor was seen (arrow).
Figure 6
Resected spleen (case 1)
Multiple nodules, consisting of proliferating blood vessels, were found
in the spleen.
Figure 7
Resected spleen (case 2)
A cystic nodule was found in the spleen.
Figure 8
Histopathological findings of the resected spleen (case 2)
The tumor consisted of proliferating blood vessels without any
epithelial abnormalities. These findings were consistent with
hemangioma.