Symptomatic splenic hamartoma: case report and literature review.

An 11-year-old girl with low-grade fever, night sweats, thrombocytopenia, and an 8-year history of progressive splenomegaly underwent an elective splenectomy. Pathologic diagnosis was multiple splenic hamartoma. The patient's symptoms resolved after the splenectomy. Since first described by Rokitansky in 1861, approximately 140 cases of splenic hamartoma have been described in the literature. Most of the splenic hamartomas were discovered incidentally. A minority of these lesions were associated with hematologic symptoms such as pancytopenia, anemia, and thrombocytopenia. Only 20 of the reported cases of splenic hamartoma occurred in pediatric patients. However, compared with the adult patients, nearly half of these cases in pediatric patients was associated with symptoms. Splenectomy and partial splenectomy have relieved these symptoms. With advances in imaging, splenic hamartomas are being discovered with increasing frequency. A multimodal radiologic work-up has enabled some cases of splenic hamartoma to be diagnosed preoperatively. Inclusion of this benign entity in the differential diagnoses of symptomatic splenomegaly in a pediatric patient is important in the preoperative management and counseling of the patient and family. In patients who have discrete lesions, consideration of this entity preoperatively may avoid total splenectomy.

Hepatic benign vascular tumor in infancy: correlative imaging.

The use of multiple imaging modalities to diagnose hepatic hemangioendothelioma in a neonate is demonstrated. This approach avoided operative intervention to establish the diagnosis. Tc-99m sulfur colloid and Tc-99m PIPIDA scintigraphy was used to define the nature of sonographic hypoechoic structures in the liver, and angiography was employed to confirm the suspected diagnosis.

Primary lever masses in infants.

Sixteen primary liver masses in infants less than 2 years of age collected from four centers over 12 years included six hepatoblastomas, five benign vascular tumors, three amebic abscesses, a simple hepatic cyst and a calcified cystic hematoma. The diagnostic features of the various lesions are reviewed and the efficient use of the different imaging modalities is discussed. Modern ultrasound techniques offer a diagnostic short-cut in the investigation of primary liver masses in infants and should be done early.

Localization of peripheral catheter emboli with xeroradiography.

There is an increasing incidence of venous catheter emboli coincident with the prolonged use of both peripheral and central venous cannuli. Difficulty in localizing embolized catheter fragments frequently has been a problem, especially in the pediatric patient in whom nonradiopaque catheters are used. A case of catheter embolus in a 4-week-old infant is reported and the use of xeroradiography to localize the catheter in the soft tissue of the extremity is described. Xeroradiography offers excellent definition of soft tissue architecture and therefore may be of value in a variety of situations where localization of a foreign body proves difficult.