ARDMS AB-Abdomen Exam - Topic 4 Question 4 Discussion

Actual exam question for ARDMS's AB-Abdomen exam

Question #: 4
Topic #: 4

Which is the most likely etiology of a spherical mass near the splenic hilum that is isoechoic to the normal spleen in a 55-year-old female?

ALymph node

BAccessory spleen

CPancreatic mass

DKidney mass

Show Suggested Answer

Suggested Answer: B

An accessory spleen (splenule) is a congenital variant, commonly located near the splenic hilum, and has identical echogenicity to the native spleen. This finding is benign and often incidental.

According to Rumack's Diagnostic Ultrasound:

''Accessory spleens are typically found near the splenic hilum and are isoechoic to the normal splenic parenchyma.''

Rumack CM, Wilson SR, Charboneau JW, Levine D. Diagnostic Ultrasound. 5th ed. Elsevier, 2017.

AIUM Practice Parameter for Abdominal Ultrasound, 2020.

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by Paulene at Nov 21, 2025, 12:07 AM

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Han

3 months ago

Accessory spleen is the most likely. Less invasive to consider.

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Desirae

3 months ago

I lean towards lymph node too. Need more imaging.

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Flo

3 months ago

True, but the isoechoic nature points to accessory spleen.

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Carissa

3 months ago

But what about a lymph node? Could be enlarged.

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Farrah

4 months ago

I agree, accessory spleen makes sense. It's common.

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Cecilia

4 months ago

I agree, accessory spleen seems most likely!

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Glenna

4 months ago

Wait, how can a pancreatic mass be isoechoic? Sounds off.

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Candida

5 months ago

Isn't it weird how it can look just like the normal spleen?

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Avery

5 months ago

I thought it could be a lymph node, though.

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Elly

5 months ago

Definitely leaning towards accessory spleen here.

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Jonelle

5 months ago

Lymph node? What is this, a game of Where's Waldo? Come on, people.

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Elli

5 months ago

Accessory spleen, no doubt. I can already picture the ultrasound image in my mind.

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Annmarie

5 months ago

Kidney mass? Really? I don't think that's the most likely option here.

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Johnathon

6 months ago

Hmm, a pancreatic mass near the spleen? That's an interesting one. I'll have to remember that.

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Yun

6 months ago

Definitely an accessory spleen! I've seen those before in my clinical rotations.

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Chun

6 months ago

This question feels familiar; I think we had a case study on splenic masses, and accessory spleen was the answer there too.

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Izetta

6 months ago

I think the isoechoic nature suggests it could be an accessory spleen, but I also recall a practice question about lymph nodes that looked similar.

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Laurel

6 months ago

I remember discussing accessory spleens in class, but I'm not entirely sure how to differentiate them from lymph nodes.

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Danica

6 months ago

This is the kind of question I feel prepared for. The combination of the radiographic findings and patient demographics makes me confident that an accessory spleen is the most probable explanation.

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Luis

7 months ago

I'm a bit unsure about this one. The location and imaging features don't immediately point me to one clear answer. I'll have to review my notes on differential diagnoses for splenic masses.

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Arminda

7 months ago

I think it's probably an accessory spleen. Looks similar.

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Stanford

7 months ago

I’m leaning towards lymph node, but I feel like I need to double-check the ultrasound characteristics of pancreatic masses.

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Jonell

7 months ago

Hmm, I'm a little stuck on this one. I know we covered splenic masses in class, but I'm having trouble recalling the key distinguishing features. Time to quickly review my study guide.

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Arthur

8 months ago

Okay, let's think this through step-by-step. An isoechoic mass near the spleen in a middle-aged female... Accessory spleen seems like the most likely option here.

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Yuette

8 months ago

Hmm, this seems like a tricky one. I'll need to carefully consider the key details - the location, the imaging characteristics, and the patient's age and gender.

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