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Infiltration of the spleen in hematopoietic malignancy can produce diffusely increased parenchymal echo return on gray scale ultrasonography. In 13 patients with splenomegaly and an increased splenic echo pattern, nine had diagnoses of hematopoietic malignancy. Contrary to previous reports describing low-level echo return and increased anechoic conditions with infiltrating malignancy of the spleen, the patients in this report show that increased splenic echogenicity can be associated with malignant involvement.

Increased echogenicity of the spleen in benign and malignant disease