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Abdominal splenosis and its differential diagnoses: What the radiologist needs to know
Authors:Federica Vernuccio  Mariangela Dimarco  Giorgia Porrello  Roberto Cannella  Silvestro Cusmà  Massimo Midiri  Giuseppe Brancatelli
Affiliation:1. Dipartimento Promozione della Salute, Materno-Infantile, di Medicina Interna e Specialistica di Eccellenza G. D''Alessandro, University of Palermo, Palermo, Italy;2. I.R.C.C.S, Centro Neurolesi Bonino Pulejo, Messina, Italy;3. Hôpitaux Universitaires Beaujon, Radiology, Université Paris VII, Clichy, France;4. Dipartimento di Biomedicina, Neuroscienze e Diagnostica avanzata (BIND), University of Palermo, Palermo, Italy;5. Radiology department, Oncologic Hospital “La Maddalena”, Palermo, Italy;1. New York Presbyterian Hospital, Columbia University Medical Center, Department of Radiology, New York NY;2. New York Presbyterian Hospital Brooklyn Methodist, Department of Radiology, Brooklyn, NY;1. Department of Interventional Radiology, University of Texas MD Anderson Cancer Center, Houston, TX;2. Department of Radiology, Kaiser Permanente of Northern California, Sacramento, CA;3. Department of Diagnostic Radiology, University of Texas MD Anderson Cancer Center, Houston, TX;4. Department of Breast Medical Oncology, University of Texas MD Anderson Cancer Center, Houston, TX;5. Department of Anatomical Pathology, University of Texas MD Anderson Cancer Center, Houston, TX;6. Department of Biostatistics, University of Texas MD Anderson Cancer Center, Houston, TX;1. Department of Radiology, Vancouver General Hospital, University of British Columbia, Vancouver, British Columbia, Canada;2. Department of Radiology, Emory University Hospital, Atlanta, GA;1. Michigan State University College of Human Medicine, Grand Rapids, MI;2. Department of Radiology, University of Arkansas for Medical Sciences, Little Rock, AR;3. Wake Forest Baptist Health, Department of Radiology, Medical Center Boulevard, Winston-Salem, NC;4. Department of Surgery, Thomas Jefferson University Hospital, Philadelphia, PA;5. Department of Interventional Radiology, University of California Los Angeles, Los Angeles, CA;6. Department of Radiology, Division of Vascular and Interventional Radiology, University of Michigan Health System, Ann Arbor, MI;7. Department of Information and Statistics, Chungnam National University, Daejeon, South Korea;8. Department of Radiology, Division of Interventional Radiology, University of Washington, Seattle, WA;1. Department of Radiology, The University of Texas MD Anderson Cancer Center, Houston, TX;2. Department of Radiology, Brigham and Women''s Hospital, Boston, MA;3. Department of Radiology, Mayo Clinic Scottsdale, Scottsdale, AZ;4. Department of Radiology, University of Missouri, Columbia, MO;5. Department of Diagnostic Radiology, University of Utah, Salt Lake City, UT
Abstract:Splenosis is a benign acquired condition characterized by the presence of heterotopic viable splenic tissue in other organs or within cavities such as peritoneum, retroperitoneum, or thorax after splenic trauma or surgery. Abdominal splenosis is often an incidental finding and computed tomography and magnetic resonance usually allow a confident diagnosis. The typical enhancement that parallels the spleen is a useful hallmark of splenosis. Splenic implants lack contrast uptake in the hepatobiliary phase and show high signal at high b-values on diffusion-weighted images. In some cases splenosis may mimic malignant and benign conditions in the peritoneum as well as in hollow and parenchymal abdominal organs and further investigations – including scintigraphy with Tc99m-labelled heat-denatured red blood cells or biopsy – are sometimes required in challenging cases. This pictorial essay reviews the imaging presentation and potential differential diagnosis of splenosis according to the site of implantation. A prompt and accurate radiological diagnosis of splenosis can avoid unnecessary biopsy or surgery.
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