Which of the following is the most common benign splenic neoplasm?

• A. Hemangioma
• B. Hamartoma
• C. Lymphangioma
• D. Angiosarcoma

Answer: (A)

Benign splenic tumors are usually vascular lesions, and the most common one is a splenic hemangioma. It is a benign proliferation of blood-filled vascular channels in the spleen. Many are found incidentally and cause no symptoms, though large lesions can lead to splenomegaly or, rarely, rupture. On imaging, splenic hemangiomas exhibit vascular characteristics: they tend to be well circumscribed and show a pattern of enhancement that mirrors other hemangiomas, often with peripheral nodular enhancement and progressive fill-in on delayed phases. The other options are less typical: lymphangiomas are rare lymphatic malformations of the spleen; hamartomas are disorganized but benign splenic tissue and occur less frequently; angiosarcoma is a malignant vascular tumor and is not a benign lesion. So the most common benign splenic neoplasm is a hemangioma.