From the Research
Splenectomy is the recommended treatment for splenic lymphangioma, as it can prevent life-threatening complications such as rupture or infection, and should be considered even in adults with symptomatic or large lesions. Splenic lymphangioma is a rare, benign vascular tumor characterized by dilated lymphatic channels within the spleen, typically presenting in childhood but can be found incidentally in adults during imaging for unrelated conditions 1. The clinical picture is variable, with small lesions often being incidentally detected, while larger lesions can result in compression of organs, causing pain or rupture even after minor trauma 1.
Treatment Options
- For small, asymptomatic lesions, observation with periodic imaging may be appropriate, but for larger lesions (>4 cm) or those causing symptoms, surgical intervention is recommended 2.
- Complete splenectomy is the traditional approach, though partial splenectomy may be considered in children to preserve splenic immune function, with a systematic review of 2130 published cases showing good results but also severe complications 3.
- Laparoscopic splenectomy is a preferred treatment for patients with suspected cystic lymphangioma, as it permits a total pathological examination of the spleen and should be preferred to partial splenectomy due to possible multiple lesions 4, 5.
Postoperative Care
- Following splenectomy, patients require vaccinations against encapsulated organisms (pneumococcus, meningococcus, and Haemophilus influenzae type b) and lifelong antibiotic prophylaxis in some cases, to prevent severe postsplenectomy sepsis 3.
- Histologically, these lesions contain dilated lymphatic spaces lined by endothelial cells and filled with proteinaceous lymphatic fluid, and the etiology is thought to be congenital malformation of lymphatic vessels, which may be associated with other lymphatic malformations in syndromes like Klippel-Trenaunay syndrome or Proteus syndrome 1.