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PubMed1998

Visualization of intestinal splenosis by somatostatin receptor scintigraphy.

A case of intestinal splenosis in a splenectomized patient is presented. (111)In-DTPA-D-Phe-1-octreotide ((111)In-OCT) scintigraphy, computed tomography, as well as magnetic resonance imaging suggested a tumor in the small intestine. The histopathological finding after operation revealed an intestinal splenosis. This case illustrates that intestinal splenosis may mimic a tumor by (111)In-OCT scan. In a splenectomized patient, a splenosis should therefore be considered.

Adult↗
PubMed1998

Isolated hepatic splenosis: first reported case.

Splenosis is the autotransplantation of splenic tissue, most commonly seen after traumatic splenic rupture and splenectomy. Post-traumatic splenosis is often considered a rare entity, but is probably underreported because of its asymptomatic nature. We describe the first reported case of splenosis presenting as a liver mass, indistinguishable from a liver tumor by standard preoperative evaluation. The pathophysiology, evaluation and management of splenosis is discussed as well as the decision to resect a benign appearing liver mass.

Adult↗
PubMed1994

Splenosis presenting as a left renal mass: a report of two cases.

The development of splenosis is a recognized consequence of splenic trauma. We present 2 cases of splenosis that were initially diagnosed as left renal cell carcinomas. The diagnosis of splenosis was made by technetium sulfur colloid scans. The clinical presentation and diagnosis of these 2 cases of splenosis masquerading as renal cell carcinoma are reviewed.

Adult↗
PubMed2003

[Hepatic splenosis diagnosed by fine-needle cytology].

A case of hepatic splenosis, diagnosed by FNA cytology, in a 56 years old cirrhotic man is reported. The cytologic material, aspirated from a 4.8 cm "suspicious for hepatocarcinoma" nodule, showed, within a hematic background, small-medium sized lymphoid cells, neutrophils and eosinophils granulocytes, histiocytes with large cytoplasm, plasma cells; mixtures of these cells, within a reticular network, were often aggregated in large structures, in which endothelial cells organized in vascular-like structures were also visible. The cell block, showed sinusoidal structures, lymphoid follicular aggregates and fibrous septa, strongly suggesting the micromorphology of the normal spleen. Splenosis is an autotransplant of splenic tissue, morphologically organized in non-capsulated, functioning, self-limited nodules, secondary to a post-traumatic splenectomy. Usual presentation of this condition is the presence of several bluish nodules on the peritoneal surface. Nevertheless, sporadic cases in other organs have been reported. To the best of our review of the Medical Literature, a hepatic splenosis is an exceptional even and the present is the first case in this location diagnosed by FNA cytology. The present one is also the case with the largest latency between the splenectomy and the splenosis detection (43 years).

Accidents, Traffic↗
PubMed2004

Consider the diagnosis of splenosis for soft tissue masses long after any splenic injury.

Splenosis represents the autotransplantation of splenic tissue after splenic trauma or surgery. Disruption of the splenic capsule causes fragments of splenic tissue to be seeded mainly throughout the peritoneal cavity, where they are characterized by diffusely scattered bluish implants. Extraperitoneal locations are very rare and mainly include the thoracic cavity after thoracoabdominal trauma with simultaneous splenic rupture and diaphragmatic laceration. We retrospectively identified all patients in the pathology registry with the diagnosis of splenosis between December 1974 and July 2003 at our urban teaching hospital. Data collected included presenting signs and symptoms, history, imaging studies, treatment, pathology, and outcome. Five cases of splenosis were identified and described. Location of the splenosis was intraperitoneal in two and intrahepatic, intrathoracic, and subcutaneous in one each. In these cases, there was an average interval of 29 years between splenic injury and diagnosis, and most were found incidentally. One of the cases was managed entirely laparoscopically and another thoracoscopically.

Adult↗
PubMed1995

Laparoscopic removal of pelvic splenosis. A case report.

Splenosis is the autotransposition of splenic tissue and is rarely encountered by the gynecologist. Most patients with splenosis are asymptomatic but may present with gynecologic symptoms. There are few reports in the gynecologic literature describing the management of pelvic splenosis. This paper reports the first case of laparoscopic management of pelvic splenosis.

Adult↗
PubMed1993

[Post-traumatic asplenia and splenosis].

After splenectomy for traumatic spleen rupture posttraumatic asplenia occurs. In such a state different pathophysiological changes occur in the peripheral blood and in the immunologic response as well as local changes in the form of splenosis, that is, changes due to trauma-induced autotransplantate of the spleen tissue particle. The study discusses as yet obscure pathogenesis, consequences and significance of these changes, including an increased incidence of sepsis (postsplenectomy sepsis, the so-called OPSI syndrome). In a series of eight patients with posttraumatic asplenia, in seven cases splenosis was detected by means of scintigraphy with labeled erythrocytes. Although splenosis is rarely found in general population, and is usually asymptomatic, diagnostic procedures show that it can mimic other pathological processes causing differential diagnostic difficulties. Because of this the authors are of the opinion that the detection of splenosis necessitates a scintigraphic examination of splenectomized patients; if it is confirmed is should be recorded in medical documentation.

Humans↗
PubMed1977

Intrathoracic splenosis.

Intrathoracic splenosis is a rare complication of combined diaphragmatic and splenic injury. This is the 79th reported case of splenosis and the seventh case of intrathoracic splenosis. That intrathoracic splenosis can mimic carcinoma of the lung on chest roentgenogram is exemplified by the similarity between the patient's chest film and that of his brother who died of lung cancer during the patient's hospital stay.

Diagnosis, Differential↗
PubMed1992

The histological features of splenosis.

This study presents a detailed histological analysis of two cases of splenosis, including one of the largest nodules to be reported. Splenosis may exhibit red and white pulp that appears histologically and immunohistochemically normal by routine methods, and a well-developed capsule and trabeculae may form. The capsule may be thicker than in the normal spleen but is otherwise indistinguishable and may contain fibrous, elastic and smooth muscle elements. These findings are in contrast to previously published works which have described poorly-developed white pulp, capsule and trabeculae in splenosis. The histological pattern may depend on the blood supply to the autotransplanted splenic tissue in the early days after implantation. The close resemblance that splenosis may show to an accessory spleen suggests that histological examination may have a limited role in the distinction between these two conditions.

Adult↗
PubMed1992

Thoracic splenosis presenting with hemoptysis.

Thoracic splenosis (post-traumatic autotransplantation of splenic tissue) is rare and generally asymptomatic. We report a patient with thoracic splenosis presenting with repeated hemoptysis. The blood supply of the hypervascular splenic transplants originated from a bronchial and an intercostal artery. Hemoptysis improved after surgical exeresis of splenosis. Recognizing splenosis presenting with hemoptysis is important, since percutaneous embolotherapy could be hazardous because of the risk of ectopic splenic tissue infarction.

Chronic Disease↗
PubMed1993

Thoracic splenosis after blunt trauma: frequency and imaging findings.

OBJECTIVE: Thoracic splenosis is an uncommon sequela of simultaneous splenic and diaphragmatic injury. The aim of this prospective study was to evaluate the prevalence of thoracic splenosis in 17 subjects who had sustained splenic and diaphragmatic injury and to describe the CT and MR features of thoracic splenosis. SUBJECTS AND METHODS: All patients had 99mTc-RBC scintigraphy. Subjects with radionuclide uptake in the thorax were further examined with radiography, CT, and MR imaging of the chest. RESULTS: Three subjects (18%) had evidence of ectopic splenic activity in the left side of the thorax. The CT features consisted of one pleural nodule and two pleural masses. The MR appearance of the ectopic splenic tissue was similar to that of normal spleen. CONCLUSION: Thoracic splenosis occurs with moderate frequency after combined splenic and diaphragmatic injury. The CT appearance is that of pleural masses or nodules. The MR appearance is relatively similar to that of normal spleen.

Adult↗
PubMed2001

Pulmonary parenchymal splenosis.

We describe the cytologic findings of a case of pulmonary parenchymal splenosis, a rare condition that follows lacerating trauma to the spleen, and may masquerade as a metastatic neoplasm. Approximately 24 cases of thoracic splenosis have so far been reported, the vast majority presenting as pleural-based nodules, and the cytological features of only two cases, both belonging to the latter group, have been described. We believe our case report to be the first to describe the cytological features of an intrapulmonary splenosis, and its features differ from the prior cases by having a mixed inflammatory cell infiltrate, with a predominance of lymphocytes, plus pulmonary macrophages and occasional endothelial cells. This condition has variable cytological features, but the correct diagnosis can be made in the presence of appropriate history and radiographic findings. Confirmation may require biopsy or radionucleide imaging.

Adult↗
PubMed2001

Thoracic splenosis diagnosed by fine-needle aspiration cytology: a case report.

A case of thoracic splenosis diagnosed by fine-needle aspiration (FNA) of subpleural lung lesions is presented. The patient, a 49-yr-old male with a history of gunshot wound to his trunk with splenic rupture and splenectomy several years previously, presented with recent hemoptysis and multiple subpleural solid nodules shown in the left lung field by CT scan. As the possibility of a metastatic malignancy vs. mesothelioma was entertained, an FNA was performed on one of these lesions, revealing lymphoid tissue with abundant vascularity simulating the structure of splenic tissue. In view of this finding, supported by the absence of splenic outline in the CT radiograph, the diagnosis of splenosis was made. This is the fourth reported case of thoracic splenosis in which FNA cytology was utilized for diagnosis, yet the first in which the diagnosis was based exclusively on the FNA cytologic findings. Clinical, pathologic, and diagnostic aspects of this entity are discussed.

Biopsy, Needle↗
PubMed2006

Diagnostic difficulties of pelvic splenosis: case report.

We report the case of a 38-year-old woman who presented with chronic lower abdominal pain. Her past medical history included a splenectomy due to abdominal trauma. Ultrasound examination revealed four pelvic tumors which, upon laparotomy, were found to be the result of splenosis. Approximately 100 cases of splenosis have been reported but only a minority of them have been published in the gynecological literature. Our case indicates that those involved in pelvic scanning (even of asymptomatic women) and/or treating those complaining of lower abdominal pain or presenting with pelvic tumors should be aware of splenosis as a possible diagnosis.

Abdominal Pain↗
PubMedDate not supplied

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.

Adult↗
PubMed2001

Evaluation of risk of splenosis during laparoscopic splenectomy in rat model.

Laparoscopic splenectomy (LS) is an alternative to open surgery. However, there is a theoretic risk of splenosis and abdominal cavity dissemination of splenic cells if the splenic capsule is broken, as seen by experimental evidence of tumoral cell mobilization by the pneumoperitoneum. We evaluated the features of splenosis after splenectomy operated via an open approach or under laparoscopic control in an experimental model in the rat. A total of 65 Sprague-Dawley rats were distributed in seven groups that included the open approach, CO2 pneumoperitoneum LS, or wall lift LS with or without a splenic graft. Splenic function was evaluated 90 day later through (1) scintigraphy with Tc-labeled heat-damaged erythrocytes; (2) determination of circulating "pitted" cells; and (3) analysis of the distribution of splenic pulp in the peritoneal cavity. Scintigraphy did not show viable residual tissue in any group after splenectomy; splenic activity in the splenic fossa was observed in 40% of the animals with grafts. Splenectomy increased the "pit" cell count, but it was reduced to normal values with a splenic graft. Necropsy showed normal splenic tissue in the splenic fossa in 100% of animals with a graft. Abdominal implants were observed significantly more frequent after CO2 LS than after the open surgery or a wall lift LS (80% vs. 20% vs. 30%; p < 0.05). In addition, trocar site implants were observed with CO2 LS (n = 3) or wall lift LS (n = 2), whereas there were no implants in the wound in the open group. We conclude that in an experimental rat model the pneumoperitoneum may facilitate abdominal splenosis after LS if the splenic capsule is ruptured or if splenic tissue spills compared with surgery without gas (open or laparoscopic).

Abdominal Muscles↗
PubMed2002

Intrahepatic splenosis: a case report.

Splenosis is heterotopic autotransplantation and seeding of splenic tissue. In the literature, only a few cases of splenosis involving the liver and the radiologic characteristics of these lesions have been reported. We report a case of intrahepatic splenosis diagnosed by ultrasound, computed tomography, magnetic resonance imaging and scintigraphic features. To our knowledge, our patient is the first case diagnosed only by radiologic and radionuclide examination without any intervention.

Adult↗
PubMed2001

Splenosis in a port site after laparoscopic splenectomy.

Splenosis, the autotransplantation of splenic tissue, is most commonly seen after traumatic splenic rupture and splenectomy. It also can occur during embryonic development. Intraperitoneal, intrathoracic, and retroperitoneal sites have been reported. Although the presence of the splenic tissue often is asymptomatic and an incidental finding, it may present with pain or be confused with various pathologies including neoplasia. Because most pediatric splenectomies are performed for hemolytic disorders, parenchymal disruption must be contained to avoid recurrent disease. We present a case in which the devascularized spleen was contained in a bag and fragmented in situ. Splenosis developed in the retrieval port site after laparoscopic splenectomy and cholecystectomy. Port-site splenosis needs to be considered in the differential diagnosis of port-site pain and a palpable nodule postsplenectomy.

Abdominal Pain↗