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Splenosis is autotransplantation of splenic tissue that usually follows traumatic rupture of the spleen and/or splenectomy. We report a case of retroperitoneal splenosis. The correct diagnosis was made noninvasively with Tc-99m heat-damaged red blood cell scintigraphy. Surgical treatment, which was not necessary in this patient, could be avoided by splenic scintigraphy.
OBJECTIVE: To report a case of renal splenosis in a patient that had previously undergone splenectomy due to traumatic rupture. METHODS/RESULTS: A 42-year-old patient consulted for pancreatitis. A CT scan disclosed a mass behind the tail of pancreas, MRI assessment with gadolinium enhancement showed a left renal mass which was surgically resected. Histopathological analysis of the surgical specimen demonstrated splenic tissue. CONCLUSIONS: Splenosis should be considered in splenectomized patients with lesions compatible with tumors and should be distinguished from hyperplasia of accessory spleens.
Thoracic splenosis is a rare occurrence that has usually been diagnosed by invasive procedures to allow a pathologic diagnosis to be reached. A firm diagnosis can now be made with the help of new, noninvasive imaging techniques. We report the case of a 34-year-old man with a history of severe thoracic-abdominal injury, including rupture of the spleen and left diaphragm. During computed tomography of the thorax related to a different diagnosis, nonspecific nodules were observed, although the patient was asymptomatic. A suspected diagnosis of thoracic splenosis was confirmed by technetium-99 sulfur colloid scintigraphy.
Splenosis should be considered in the differential of any patient with a history of splenic trauma or removal and a solid enhancing mass near or within the kidney. Splenosis is the autotransplantation of splenic tissue associated with splenic trauma or surgery, and can be diagnosed preoperatively, avoiding unnecessary surgery.
The development of splenosis is a known consequence of splenic rupture. A case is presented of acute appendicitis in a patient with a past history of abdominal trauma who required laparotomy for unknown reasons. During appendicectomy a mass was found in the mesoappendix which proved to be evidence of splenosis.
We present one case of peritoneal splenosis, which was not confirmed by the splenic scintiscan with 99mTc-sulphur colloid, but whose diagnosis, carried out during a second scintiscan with 99mTc-heat-damaged RBC, was confirmed by laparotomy and histology. This case confirms that, for the diagnosis of splenosis, heat-damaged RBC scintigraphy must be used rather than either sulphur colloid scintigraphy or computed-tomography.
Splenosis is an unusual complication of abdominal trauma. We report a case of splenosis identified on ultrasonography (US) and computed tomography (CT). Usually it is a latent disease and an incidental finding, but it may be diagnosed by US and CT.
Splenosis, an autograft of splenic tissue, may occur after a traumatic spleen rupture or splenectomy. Usually asymptomatic, this pathology may uncommonly produce symptoms which justify radiologic investigations. We are presenting the case of a young boy with a Wiskott Aldrich syndrome and who developed splenosis simulating an abdominal lymphoma.
Different immune functions were analysed in detail in 41 patients who had been splenectomized after a traumatic rupture of the spleen within four years after surgical intervention. Patients were assigned to one of the following groups as judged by liver/spleen scintigraphy: (1) patients with reimplanted splenic tissue, (2) patients with splenosis, and (3) patients without splenic tissue. Leukocytosis and an increased number of total lymphocytes as well as B-cells were observed in patients of all groups. In addition, the number of circulating T-suppressor cells was significantly increased in patients with no detectable splenic tissue. In contrast, serum concentrations of immunoglobulins and complement components were in the normal range; similarly, phagocytosis-associated functions of the patients' neutrophils and monocytes were found to be unimpaired (chemiluminescence and particle uptake). However, in all groups of splenectomized patients a deficiency in specific serum opsonic activity against a strain of Escherichia coli (O:102, H:6) could be detected. We conclude that neither splenosis nor autologous reimplantation of splenic tissue restores opsonic deficiency caused by splenectomy.
Two rare cases of intrathoracic splenosis are reported. This phenomenon occurs almost exclusively in young men who have experienced splenic rupture and diaphragmatic laceration. The late occurrence of splenosis in the thoracic cavity poses problems in the differential diagnosis of solitary or multiple pleural-based nodules. It is important to recognize this entity from a clinical, radiographic, and therapeutic perspective.
Splenosis following splenic trauma is a common but underdiagnosed entity before surgical exploration. In all previously reported cases the ectopic splenic tissue was distinctly separate from the kidney. To our knowledge we report the first known case in which the splenic tissue was located in direct apposition with the kidney. Using conventional imaging techniques, including renal ultrasonography, abdominal computerized tomography and selective renal arteriography, this ectopic splenic tissue appeared to be part of the left kidney and was indistinguishable from renal cell carcinoma. The pathophysiology, clinical presentation and diagnostic studies of splenosis are reviewed.
Definition, diagnosis, and therapy of splenosis are demonstrated by presenting a case report. Operative pelviscopy, performed twice, would be the best method for diagnosis and therapy of splenosis compared with the treatment with radiation or laparotomy.
Splenosis is an unusual complication of splenic trauma. The computed tomographic (CT) appearance of splenosis is described. One should consider this diagnosis when faced with a history of splenic trauma and multiple round or oval masses at CT.
We believe this report represents the first of traumatic hemorrhage from splenosis which necessitated operation. We discuss previous reports of complications as a result of splenosis. With the increased interest in autotransplantation of splenic remnants following splenectomy, we expect that this complication may be reported with increasing frequency.
Intrathoracic splenosis is a rare sequel of left thoracoabdominal injury. A case simulating esophageal leiomyoma is presented. As in most earlier cases, the diagnosis was established only at thoracotomy. As splenosis is asymptomatic and may have some beneficial immunologic effects, surgical removal is inadvisable. The 23 previously published cases and the possibility of nonsurgical diagnosis are discussed.
Peritoneal splenosis is a frequent condition after traumatic spleen fracture, which, given that it is usually asymptomatic, is often not diagnosed unless a laparotomy is performed for some other reason. The case is presented of a 9 year old boy splenectomized a few years earlier because of traumatism, who again suffers abdominal injury with the development of hemoperitoneum, observing during surgery multiple splenosis foci disseminated all over the abdominal cavity, some of which present rupture and hemorrhage, constituting the cause of hemoperitoneum.
This is the first reported case of simultaneously occurring pelvic splenosis and Mayer-Rokitansky-Kuster-Hauser syndrome. No other congenital or anatomic abnormalities were observed in the patient, and she had no history of abdominal trauma or surgery. Endometriosis was suspected initially during laparoscopy for pelvic pain. After tissue removal at laparotomy, the histologic evaluation established the diagnosis of splenosis. Biopsy at laparoscopy should be considered to confirm the diagnosis in the presence of a congenital anomaly and lesions suspected of being endometriotic.
Thoracic splenosis is the autotransplantation of splenic tissue into the thoracic cavity after thoracoabdominal trauma. We report a case of thoracic splenosis in a 35-year-old woman who had had a thoracoabdominal gunshot wound 12 years earlier. A review of the literature revealed 15 cases already reported. All patients had an asymptomatic thoracic lesion discovered on a plain chest film 9 to 32 years (mean 16) after the initial accident. In 13 cases an operation was necessary to establish the diagnosis. In two cases technetium 99m and indium 111 scans established the diagnosis.