Multiple hypodense splenic lesions:
- 19 mm lesion in the inferior anterior spleen corresponding to simple cyst demonstrated on ultrasound.
- 49 mm lesion in the mid spleen (HU 26), as demonstrated on ultrasound
- 12 mm lesion in the anterior superior spleen (HU 45)
- 34 mm lesion in the subcapsular superior spleen (HU 23)
- 16 mm lesion in the posterior superior spleen (HU 33)
The liver, adrenal glands, kidneys, pancreas and bowel including appendix are unremarkable. No free intra abdominal fluid or air identified.
Minor dependent lung changes in image bases. The appendix is normal in appearance.
Prominent right hilar fossa and para-aortic lymph nodes measuring at the upper limits normal.
Conclusion
Multiple hypodense splenic lesions are non-specific in appearance on CT criteria. Their density is not of simple cysts however there is no rim enhancement to suggest an abscess. Review of the recent US suggests these lesions likely to reflect epidermoid cysts.
Retrospective correlation with an external CT from a year ago shows these lesions to be unchanged, confirming the diagnosis of epidermoid cysts.