Purpose or Case Report: Learning Objective: This educational exhibit will review a variety of pediatric splenic lesions and their appearance on various specific multimodality imaging finding as seen on ultrasound, computed tomography (CT), and magnetic resonance imaging (MRI). This exhibit will also review an algorithm to approaching non-cystic splenic lesions in pediatrics.
Methods & Materials: Background: The spleen is often termed the “forgotten organ”. The Spleen is involved in many pathologic processes in infants and children. These may be part of systemic illness or may be isolated to the spleen. This educational exhibit will review many benign and malignant non-cystic lesions of the spleen as well as give an overview of the normal spleen at different ages.

Splenic lesions are most often detected on imaging incidentally and are referred to as “incidentalomas”. It is often difficult to distinguish whether non-cystic incidentalomas are benign or malignant solely on the basis of imaging characteristics. MRI is the most useful modality in aiding the radiologist in making a definitive diagnosis and providing reassurance. This will evade seeking a histologic diagnosis, which is especially important considering the relatively low rates of invasive cancers in the pediatric population. This education exhibit will also provide an algorithm to help make a definitive diagnosis when diagnosing non-cystic splenic lesions.
Results: Imaging Findings:
Congenital Anomalies of the Spleen:
Polysplenia
Asplenia
Wandering Spleen
Malignant Neoplasms:
Lymphoma
Angiosarcoma
Metastatic lesions
Benign Neoplasms:
Hemangiomas
Lymphangiomas
Hamartomas
Peliosis
Non-neoplastic Lesions of the Spleen
Sarcoidosis and Granulomatous Diseases
Infection
Extra-medullary Hematopoiesis
Splenomegaly
Trauma
Algorithm for Non-cystic Splenic Lesions:
The Usefulness of MRI and An Approach to Non-cystic Lesions
Conclusions: Although primary and secondary neoplasms in the spleen are infrequently encountered, the spleen should not be forgotten.