Splenic Lymphatic Malformations: Clinical Characteristics of 35 Patients and Literature Review.

Background: Primary lesions of the spleen are very rare, and splenic lymphatic malformations (SLMs) account for 0.007% of all splenic lesions; thus, SLMs are often ignored in clinical practice. The aim of this study was to review the clinical and imaging features of 35 patients with SLMs, classify them on imaging and provide a reference for treatment.

Methods: We reviewed the records of patients with SLMs who entered the medical system at our institution from December 2008 to March 2023. The clinical characteristics and imaging features of these patients were collected to classify SLMs.

Results: In our case series, 82.9% (29/35) of the patients with SLMs were adults, whereas only 6 patients were children, and 97.1% of (34/35) patients were women. A total of 68.6% (24/35) of the patients were asymptomatic. Seven patients experienced complications, such as cyst rupture, cyst bleeding, and mass effects. On imaging, the average cyst diameter of the SLMs was 5.2 cm, and macrocystic SLMs (23/35) were the most common. SLMs can be divided into isolated SLMs, multiple SLMs, and diffuse SLMs, of which 17 cases were isolated lesions, 14 cases were multiple lesions, and 4 cases were diffuse lesions. Some lesions were accompanied by cyst wall calcification. All patients underwent surgical removal, and no signs of recurrence were found during the 5-year postoperative follow-up.

Conclusion: SLMs are uncommon with insidious onset, and most patients are asymptomatic; however, complications still exist. Partial splenectomy is an option for isolated SLMs, whereas total splenectomy is necessary for diffuse SLMs.