Splenic lesions are unusual cysts or inflamed areas of surface tissue on the spleen. Lesions can be caused by many different illnesses and adverse health conditions, including bacterial and viral infections, abnormal buildups of immune cells, cancer, and direct physical trauma to the organ. Most splenic lesions do not cause physical symptoms, though dull pain and mild abdominal swelling may be present in some cases. Doctors generally try to identify and treat the underlying cause of lesions in order to prevent complications. Rarely, a lesion can lead to the development of an abscess or cause a rupture that needs to be addressed in an emergency room.
The spleen is a relatively small organ found in the upper abdomen near the liver. It plays a role in filtering red blood cells and stimulating the immune system's response to bacteria, viruses, and other pathogens in the body. Since the organ receives blood and lymph, it is susceptible to infections that spread from the lymph nodes. Splenic lesions can occur when infection spreads within the spleen and damages the tissue lining. Blood cancers such as leukemia may cause malignant lesions to develop, and blunt trauma to the abdomen can cause deep tissue damage on the spleen.
Another possible cause of splenic lesions is a disease known as sarcoidosis, which can also affect the lungs, liver, and lymph nodes. Sarcoidosis causes small clusters of abnormal immune cells to grow, which causes inflammation and swelling of nearby tissue. The resulting lesions may be accompanied by fever, fatigue, weight loss, and constant abdominal pain.
Splenic lesions can usually be detected with the aid of computerized tomography (CT) and magnetic resonance imaging (MRI) scans. A doctor might perform CTs or MRIs with the intention of looking for lesions or notice them incidentally when screening for other problems. When a lesion is detected, a series of blood tests are performed to look for an underlying cause. Biopsy may be necessary if a proper diagnosis cannot be confirmed with blood tests and imaging scans.
Treatment for splenic lesions largely depends on the underlying cause and the severity of symptoms. In the case of a bacterial infection, a course of oral or intravenous antibiotics is usually necessary. If an abscess develops, a surgeon may decide to excise it or drain it with a specialized needle. Sarcoidosis symptoms are generally treated with anti-inflammatory drugs and immune system-suppressing drugs. A combination of chemotherapy, radiation, and surgery may be necessary if a lesion is found to be cancerous. If the spleen ruptures or stops functioning properly as a complication of splenic lesions, it may need to be removed altogether.