What to Do When a Splenic Mass Has Suspicious Imaging Features

When a splenic mass is discovered incidentally and imaging raises concern — rather than pointing clearly to a benign process — a structured evaluation pathway is warranted before any decisions about management.

Clinical Scenario

This protocol applies to a splenic mass demonstrating one or more of the following suspicious imaging characteristics:

Heterogeneous signal or attenuation
Abnormal enhancement
Irregular margins
Necrosis
Splenic parenchymal or vascular invasion
Substantial enlargement

Approach

Further diagnostic evaluation plays a central role in this setting — though the specific modalities, sequencing, and the steps required before any potential intervention are detailed in the full protocol.

Instant Access to Structured Evidence-Based Regimens

References

Suspicious imaging features: heterogeneous, enhancement, irregular margins, necrosis, splenic parenchymal or vascular invasion, substantial enlargement.
Further evaluation with PET or biopsy is recommended for incidentally discovered splenic masses with these features.

DOI: 10.1016/j.jacr.2013.05.020

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