Abdominal splenosis and its differential diagnoses: What the radiologist needs to know

Vernuccio, Federica; Dimarco, Mariangela; Porrello, Giorgia; Cannella, Roberto; Cusmà, S; Midiri, Massimo; Brancatelli, Giuseppe

doi:10.1067/j.cpradiol.2020.04.012

Cited by 19 publications

(21 citation statements)

References 35 publications

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“…One case report with a literature review showed that 66.7% of patients with intrapancreatic accessory spleen ended up undergoing unnecessary pancreatic resections [ 13 ]. With advanced imaging techniques and early detection, fear of overtreatment of this benign incidental process exists [ 18 , 19 ].…”

Section: Discussionmentioning

confidence: 99%

Intrapancreatic Accessory Spleen Diagnosed As Neuroendocrine Tumor: The Dangers of False Positives and Their Implications in Subsequent Management

Kripalani

Patel

Joneja

et al. 2021

Cureus

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This case serves as a reminder to consider ectopic splenic tissue in the differential diagnosis of pancreatic masses. The literature shows a lack of awareness and overtreatment of this condition due to clinical and radiologic concern for malignancy, namely neuroendocrine tumors (NETs) identified on positron emission tomography (PET)-CT NETSPOT. Given the vast difference in management and prognosis of ectopic splenic anomalies and malignant neoplasms involving the pancreas, accurate diagnosis is imperative to avoid unnecessary invasive procedures such as Whipple or distal pancreatectomy and splenectomy, which are associated with increased morbidity and mortality.

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Section: Discussionmentioning

confidence: 99%

Intrapancreatic Accessory Spleen Diagnosed As Neuroendocrine Tumor: The Dangers of False Positives and Their Implications in Subsequent Management

Kripalani

Patel

Joneja

et al. 2021

Cureus

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“…Diagnosis of HS can present a dilemma, particularly when patients have other comorbidities which may increase the likelihood of a malignant etiology, such as cirrhosis, or when comorbidities alter imaging characteristics, such as in End Stage Renal Disease (ESRD). The diagnostic gold standard for splenosis is pathologic diagnosis via biopsy [1] . However, if possible, this should be avoided, as this is an invasive procedure accompanied by complication risks (i.e.…”

Section: Discussionmentioning

confidence: 99%

“…bleeding, infection), patient inconvenience, and use of health system resources (including time of procedural physician and pathologist). The reference standard imaging modality is scintigraphy with Tc-99m labelled heat-denatured red blood cells (Tc-99m-DRBC) [5] , [10] , however increasingly splenosis is confidently diagnosed with multiphasic cross-sectional imaging, particularly MRI, with multiple published reports outlining imaging features of both general and hepatic splenosis [ [1] , [2] , [3] , [4] , [5] , [8] , [9] , [10] , [11] ,].…”

Section: Discussionmentioning

confidence: 99%

“…Splenosis, originally defined by Buchbixder and Lipkoff, is the autotransplantation of functioning splenic tissue virtually anywhere in the body [1] . At up to 67%, splenosis is an overall common diagnosis in patients with a history of splenectomy or splenic trauma [ 1 , 2 , 3 ]. However, the overall incidence is uncertain, and likely higher, as the finding is often incidental [4] .…”

Section: Introductionmentioning

confidence: 99%

“…However, the overall incidence is uncertain, and likely higher, as the finding is often incidental [4] . Hepatic splenosis, on the other hand, is a rare finding and is often mistaken for a malignant hepatic mass based on its imaging features, such as rapid arterial enhancement, washout appearance, or elevated signal intensity on high b-value diffusion weighted imaging [ 1 , 5 ]. Confident diagnosis of this benign entity is beneficial to avoid unneeded invasive procedures and patient anxiety.…”

Section: Introductionmentioning

confidence: 99%

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A case of hepatic splenosis in the setting of iron overload; multimodal and literature review

Richardson

Gardner

Eberhardt

et al. 2021

Radiology Case Reports

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Hepatic splenosis, a rare entity, is the ectopic implantation of splenic tissue into the hepatic parenchyma, most often incidentally seen in patients with a history of splenic trauma and splenectomy. We present a unique case of hepatic splenosis in a patient with hemosiderosis and splenectomy following the incidental finding of hepatic masses on pretransplant imaging. Final diagnosis was made based on cross-sectional imaging characteristics matching that of the left upper quadrant splenules alone. We discuss common characteristics of hepatic splenosis on multiple modalities, the effect of iron deposition on the imaging characteristics of hepatic and splenic tissue and how that impacts the differential and diagnosis. This case highlights the unique imaging characteristics hepatic splenosis can have particularly in the setting of hemosiderosis. Hepatic splenosis imaging diagnosis has a significant advantage over tissue diagnosis in terms of decreased risk, time and cost.

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Thoracic splenosis: Precision medicine can prevent thoracic surgery

Harb,

Fattore,

Saththianathan

et al. 2024

Respirology Case Reports

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Thoracic splenosis is a rare condition referring to the auto‐transplantation of splenic tissue into the thoracic cavity following splenic trauma. We present a case of thoracic splenosis in a 62‐year‐old man who at the age of 17 suffered three gunshot wounds to the posterior thorax and abdomen, requiring a splenectomy and intercostal catheter insertion. In 2007, he underwent a thoracotomy and biopsy of a left sided pulmonary mass which was complicated by a haemothorax requiring an emergent return to theatre and rib resection to achieve haemostasis. The biopsy revealed granulation tissue. In 2023, Technetium‐99m (Tc‐99m) heat‐damaged erythrocyte scintigraphy confirmed the diagnosis of thoracic splenosis. This case highlights the importance of recognizing this uncommon condition to prevent unnecessary investigation, as well as the use of Tc‐99m heat‐damaged erythrocyte scintigraphy to confirm the diagnosis.

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Abdominal splenosis and its differential diagnoses: What the radiologist needs to know

Cited by 19 publications

References 35 publications

Intrapancreatic Accessory Spleen Diagnosed As Neuroendocrine Tumor: The Dangers of False Positives and Their Implications in Subsequent Management

Intrapancreatic Accessory Spleen Diagnosed As Neuroendocrine Tumor: The Dangers of False Positives and Their Implications in Subsequent Management

A case of hepatic splenosis in the setting of iron overload; multimodal and literature review

Thoracic splenosis: Precision medicine can prevent thoracic surgery

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