Percutaneous Image-Guided Biopsy for Non-Mass-Forming Isolated Splenomegaly and Suspected Malignant Lymphoma

<div><p>Background</p><p>The aim of this study was to evaluate the accuracy, safety, and role of splenic biopsy in the management of patients with non-mass-forming isolated splenomegaly and suspected malignant lymphoma.</p><p>Methods</p><p>Between 2001 and 2013, 137 biopsies were performed under computed tomography (CT) fluoroscopic guidance in 39 patients. All patients had splenomegaly based on the CT findings and a suspected diagnosis of malignant lymphoma based on their clinical symptoms. The spleen was the only accessible site to perform a biopsy, and no mass lesions could be identified in the spleen.</p><p>Results</p><p>The overall sensitivity, specificity, and diagnostic accuracy of image-guided biopsy for malignant lymphoma were 88%, 100% and 92%, respectively. Major complications occurred in 3 patients. In 1 patient, transcatheter arterial embolization was performed due to hemorrhage, and two patients needed blood transfusion because of hematoma development, without the need for further treatment.</p><p>Conclusions</p><p>Image-guided splenic core-needle biopsy is a safe and accurate technique with a high diagnostic accuracy in most patients who with non-mass-forming isolated splenomegaly and suspected underlying malignant lymphoma.</p></div

A 55-year-old woman with anemia underwent splenic biopsy.

<p>Immediately after biopsy, no obvious hematoma was observed around the spleen; however, mild hematoma formation was seen in the paracolic gutter (arrowheads).</p

A 64-year-old woman with pancytopenia underwent splenic biopsy.

<p>(a) Splenic biopsy was performed under computed tomography (CT) guidance. (b) Immediately after biopsy, contrast-enhanced CT showed a peritoneal hematoma and extravasation around the spleen (arrowhead). Transcatheter arterial embolization was immediately performed.</p