Losanoff et al described different types on nonparasitic splenic cysts (NPSC). These types correlate with the optimum management of the patient. The authors are from the University of Missouri in Columbia, Missouri.
Nonparasitic indicates that the cysts are not due to echinococcosis or other parasites.
Parameters:
(1) number of cysts
(2) parenchymal location
(3) location relative to vascular supply to noncystic parenchyma
Number of Cysts
Parenchymal Location
Location Relative to Vascular Supply
Type
1
marginal, peripheral, sub capsular
spares
1
1
less than half
spares
2
1
more than half
spares
3
multiple
scattered throughout
spares
4
1
hilum
compromises
5
where:
• Type 4 is shown as having 5 cysts in Figure 1. Classification of a spleen with 2 small cysts might not fit the scheme.
Type
Management
1
simple excision
2
resection with preservation of viable parenchyma
3
resection with preservation of viable parenchyma
4
typically splenectomy
5
splenectomy
where:
• Splenectomy may be performed in Type 3 if very little normal spleen remains.
• Type 4 with 2 or 3 small peripheral cysts may be a candidate for individual cyst resection.
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