KUB showing diffusely scattered splenic phleboliths

Diagnosis: Splenic phleboliths

Findings on Imaging:

  • X-ray of the abdomen shows multiple round calcifications in the region of the spleen.
  • The calcifications are well-circumscribed and appear to be located within the splenic parenchyma.
  • The appearance of the calcifications is consistent with phleboliths in the image shown
  • Splenic phleboliths are calcifications that develop within the walls of veins in the spleen. The exact cause of phlebolith formation is not well understood, but it is thought to be related to changes in blood flow or inflammation within the veins. Phleboliths are typically a benign finding and do not require any specific treatment unless there is concern for an underlying vascular lesion.

Next Steps in Management:

  • Splenic phleboliths are generally considered a benign finding and do not require any specific treatment.
  • However, it is important to differentiate phleboliths from other calcified lesions that may require further work-up, such as splenic artery aneurysms.
  • If there is any concern for an underlying vascular lesion, additional imaging, such as CT or MRI, may be necessary to further evaluate the spleen.

Key Take Away Points:

  • Splenic phleboliths are a benign finding seen on imaging and do not require any specific treatment.
  • Phleboliths are calcifications that can develop in the walls of veins, and their appearance on imaging is characteristic.
  • It is important to differentiate phleboliths from other calcified lesions that may require further work-up, such as splenic artery aneurysms.
  • Additional imaging may be necessary to further evaluate the spleen if there is any concern for an underlying vascular lesion.

Credit: Case submitted by Dr. Saaed Rad, MD.