Tuberc Respir Dis.  2013 Mar;74(3):134-139.

Combined Intrathoracic and Intraperitoneal Splenosis after Splenic Injury: Case Report and Review of the Literature

• Moon C
• Choi YJ
• Kim EY
• Lee IS
• Kim SB
• Jung SM
• Kim SK
• Chang J
• Jung JY

Abstract

Splenosis is defined as an autotransplantation of the splenic tissue after splenic rupture or splenectomy, and occurs most frequently in the peritoneal cavity. Splenosis is usually asymptomatic and is found incidentally. We report a case of combined intrathoracic and intraperitoneal splenosis in a 54-year-old male who worked as a miner for 10 years in his twenties, and was a current smoker. He was referred to our hospital for further evaluation of an incidental left diaphragmatic mass. Positron emission tomography-computed tomography and bronchoscopy were performed to evaluate the possibility of malignancy. There was no evidence of malignancy, but the spleen was not visualized. Reviewing his medical history revealed previous splenectomy, following a dynamite explosion injury. Therefore, splenosis was suspected and technetium-99m-labeled heat-damaged red blood cell scan confirmed the diagnosis. Radionuclide imaging is a useful diagnostic tool for splenosis, which could avoid unnecessary invasive procedures.

Keyword

Splenosis; Splenectomy; Radionuclide Imaging

MeSH Terms

Bronchoscopy
Electrons
Erythrocytes
Explosions
Humans
Male
Nitroglycerin
Peritoneal Cavity
Spleen
Splenectomy
Splenic Rupture
Splenosis
Nitroglycerin

Figure

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  Figure 1 (A) Chest X-ray showing a left diaphragmatic mass with irregular margin and consolidation in the right upper lobe. (B-E) Chest computed tomography. Multiple lobulated masses and nodules present along the left lower mediastinum (B), left diaphragm (C, D), and omentum (E).

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  Figure 2 (A) Positron emission tomography computed tomography (PET-CT). Multiple masses and nodules along left diaphragm and multiple small nodular lesions in the left perigastric area and omentum show faint fluoro-2-deoxygluocose (FDG) uptake. Moreover, acute and chronic inflammation with fibrosis and calcified granulomas were observed in the right upper lobe with intense FDG uptake. (B) Technetium-99m-labeled heat-damaged red blood cell scan. Multiple foci show increased uptake in the left thorax and left upper quadrant of the abdomen, consistent with thoracic and abdominal splenosis. RAO: right anterior oblique; LPO: left posterior oblique; RT LAT: right lateral; LT LAT: left lateral; RPO: right posterior oblique; LAO: left anterior oblique.

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