Differential Diagnosis for a 10 mm Splenic Nodule
The following differential diagnosis is organized into categories to help guide the thought process:
- Single Most Likely Diagnosis
- Hematoma or Traumatic Lesion: Given the patient's age and the description of the nodule as soft tissue and non-vascular, a hematoma or traumatic lesion is a plausible explanation, especially if the patient has a history of trauma or injury.
- Other Likely Diagnoses
- Splenic Cyst: Although less common, splenic cysts can present as soft tissue nodules. They are usually benign and can be congenital or acquired.
- Hamartoma: Splenic hamartomas are rare, benign tumors that can appear as soft tissue nodules on imaging. They are composed of normal splenic tissue elements but are disorganized.
- Inflammatory Pseudotumor: This is a rare, benign lesion that can occur in the spleen, often associated with inflammation or infection.
- Do Not Miss Diagnoses
- Lymphoma: Although less likely given the small size and description of the nodule, lymphoma involving the spleen can present with nodules and must be considered due to its significant implications for patient management and prognosis.
- Metastasis: Metastatic disease to the spleen is rare but can occur, especially from cancers like melanoma, breast cancer, or lung cancer. Given the potential severity of metastatic disease, it's crucial not to miss this diagnosis.
- Rare Diagnoses
- Splenic Abscess: While abscesses in the spleen are rare and usually occur in the context of immunocompromised states or specific infections, they can present as soft tissue nodules.
- Angiosarcoma: This is a rare, malignant tumor of the spleen that can present as a nodule. It's essential to consider due to its aggressive nature and poor prognosis.
- Other Rare Tumors: Including but not limited to, littoral cell angioma, or splenic sarcomas, which are exceedingly rare and often have non-specific imaging findings.