Thoracic splenosis: A diagnosis by history and imaging

Abstract:   Thoracic splenosis (TS) is autoimplantation of ectopic splenic tissue in the thoracic cavity that occurs following splenic injury. The majority of cases of TS are asymptomatic and are diagnosed in the course of an evaluation of incidentally discovered pulmonary lesions. Some cases may be difficult to diagnose, especially if features suggesting TS are not recognized. This may lead to an extensive work-up and unnecessary invasive diagnostic procedures including thoracotomy. This case report describes a 40-year-old man, who was diagnosed incidentally with TS, several years after the initial injury. Multiple, asymptomatic, left-sided pleural based lesions associated with a history of thoracoabdominal injury and splenectomy are the key points that should alert suspicion of TS, which can then simply be confirmed by a Tc-99m sulphur colloid radionuclide scan. Most patients are treated conservatively unless they are symptomatic. Physicians must recognize the key features suggesting a diagnosis of TS, order appropriate imaging studies and avoid unnecessary invasive diagnostic procedures.     

An unusual pelvic mass: Contrast-enhanced sonographic diagnosis of pelvic splenosis

Splenosis is an unusual condition representing auto-transplantation of splenic tissue following splenic trauma or surgery. When detected on imaging studies, the splenosis deposits are usually misinterpreted as pathological masses. We present a case where a pelvic mass incidentally visualized on an MRI examination, was proven to represent a deposit of splenosis by contrast enhanced ultrasound (CEUS). CEUS demonstrated persistent late-phase enhancement characteristic of splenic tissue. Ultrasound practitioners should be aware of this condition when an unusual abdominal or pelvic mass is encountered in a patient with a history of splenic trauma or surgery. CEUS is ideally suited to confirming the diagnosis.     

Intrahepatic splenosis mimicking a liver tumor

A rare case of ectopic splenic tissue in the liver is presented which mimicked a liver tumor. It is considered that some splenic tissue was seeded in the liver during the splenectomy that the patient underwent 23 years ago. Computed tomography (CT), magnetic resonance imaging (MRI), and angiographic features of this lesion were almost indistinguishable from those of other liver tumors.     

Extensive abdominal splenosis: imaging features

We present the case of a 22-year-old patient who had splenectomy in childhood after trauma and had a known chronic active infection with hepatitis C. Imaging procedures in different radiologic modalities diagnosed diffuse intraabdominal splenosis. Splenosis is a rare, severe complication of splenic trauma or surgery, but the pathogenesis is not clear. Imaging features play a key role in the diagnosis of ectopic splenic tissue, which must be differentiated from malignancies, especially from lymphoma. Splenosis itself may induce relapse of hematologic diseases, mainly autoimmune thrombocytopenia.     

盆腔脾种植误诊为卵巢肿瘤1例及文献复习

患者23岁。一年多前孕40天时查体发现盆腔包块,未处理。现排便次数增多,量少,无腹痛及便血,食欲好。既往6岁时因外伤行部分脾切除。阴道检查:子宫右后方可及约8cm×6cm×6cm包块,质硬,欠活动,无压痛。三合诊:直肠上方触及该包块,与直肠关系密切。指肛检查:距     

Pararectal mass: an atypical location of splenosis

Splenosis is the autotransplantation of splenic tissue resulting from the dissemination of cells from the pulp of the spleen after splenic injury or splenectomy. Implants can be found anywhere in the peritoneal cavity, especially on the serosal surfaces of small and large bowel, in the mesentery and diaphragm, implanted in visceral organs, within the thorax and brain, and in surgical scars and may vary in number, shape, and size. We described the sonographic, computed tomography and magnetic resonance imaging findings of pararectal splenosis in a 23‐year‐old man. The lesions appeared as multiple, well‐circumscribed, small, round, homogenously solid masses of different sizes at the retrovesical and pelvic region detected during the imaging workup of Behçet disease. © 2011 Wiley Periodicals, Inc. J Clin Ultrasound 40:443–447, 2012     

肝脏脾植入误诊为肝细胞癌1例

[摘要]?本文报道了1例肝脏左外叶脾植入误诊为肝左叶小肝癌的病例，详细描述其临床特点、实验室检查、超声、磁共振及病理结果，并进行讨论。     

Intrahepatic and intra-abdominal splenosis:A case report and review of literature

BACKGROUND Splenosis is defined as the process by which tissue from the spleen disseminates through the body and grows in an ectopic location following trauma or a splenectomy.Visceral sites of splenosis are rare.CASE SUMMARY We report a case of intrahepatic splenosis in a 57-year-old man with a history of trauma over 40 years ago who initially presented with chest pain.Findings initially mimicked malignancy but a diagnosis of intrahepatic splenosis was confirmed using computed tomography and scintigraphy with technetium-99 m heat-denatured red blood cells(Tc-99 DRBC).CONCLUSION Scintigraphy with Tc-99 DRBC is a reliable technique to diagnose splenosis and should be performed before using more invasive procedures are carried out.Splenosis should be considered as a possible differential diagnosis for a hepatic nodule in any patient with a history of abdominal trauma,previous splenectomy or atypical radiological features on imaging.     

Contrast-enhanced ultrasonographic imaging of hepatic splenosis: A case report

Rationale:Hepatic splenosis or heterotopic auto-transplantation of spleen in the liver usually occurs after either spleen trauma or surgery. It is of great importance for the differential diagnosis of hepatic splenosis and other liver tumors because surgery is usually not needed if a diagnosis of splenosis is confirmed.Patient concerns:Multiple hepatic masses were revealed by grayscale ultrasound in a 55-year-old man complaining of persistent colic in the upper abdomen after greasy food.Diagnosis:Benign neoplasm with enlarged lymph node in the gastro-hepatic ligament was suspected by contrast enhanced US. The nature of the hepatic mass was undetermined by CECT.Interventions:The lesions were surgically removed.Outcomes:Multiple splenic tissue implants in the liver and peritoneum were confirmed by pathology after surgery. The patient recovered well and was followed up for more than 1 year without recurrence.Lessons:Splenosis should be included in the differential diagnosis of focal liver lesion in patients with a history of spleen trauma or surgery. In spite of nonspecific findings on pre-contrast ultrasound, splenosis shows characteristic homogeneous hyperenhancement in arterial and portal phases, as well as prolonged hyperenhancement in the late phase for more than 5 minutes. Furthermore, the confidence of the diagnosis of splenosis may be enhanced by identifying multiple masses with similar enhancing patterns in other regions of the abdominal cavity.