Clinical and pathological characteristics of abdominal ectopic spleen: 13 cases report / 解放军医学杂志

Objective To analyze the clinical manifestation, diagnosis and pathological features of abdominal ectopic spleen (AES) cases. Methods The clinical and pathological characteristics were retrospectively analyzed along with the followup data of patients diagnosed as AES in the Changhai Hospital affiliated to Naval Medical University from Jan. 2013 to Dec. 2018. Results A total of 13 cases of AES were diagnosed, of whom 7 cases (53.8%) were found due to medical examination, and only one case was diagnosed before operation, while the rest were considered as having tumor of the abdominal organ near the mass. Out of the 13 cases, the AES in 6 cases were located at the pancreas tail. The surgical excision samples showed an appearance of nodular lesion with clear contour, and the structure of spleen parenchyma could be identified under microscope. Among the 13 cases, spleen trabecular and obvious central arterioles were absent in 2 cases with history of surgery, while the rest 11 cases shared the pathological features of spleen trabecular, central arterioles and secondary follicles. All the 13 patients survived except one died due to progression of gastric cancer and another one missing of follow-up. Conclusions The AES lacks specific clinical features, which requires antidiastole with abdominal tumors. It is inferred from clinicopathological features that splenosis may differ from accessory spleen, that is, splenosis may lack typical spleen white pulp.

Thoracic splenosis: Case report of a symptomatic case / 中华创伤杂志(英文版)

Thoracic splenosis is the autotransplantation of splenic tissue in the left thoracic cavity as a result of a splenic injury. This rare pathology is usually asymptomatic and may be discovered on incidental imaging, but the diagnosis often requires invasive procedures such as surgery in order to eliminate a neoplasic origin. We report a rare symptomatic case of a 39-year-old man presenting with chest pain and multiple nodules revealed on a computed tomography scan. The patient underwent a surgical exploration and the pathological studies concluded to a thoracic splenosis. Indeed, the previous medical history of the patient revealed a left thoraco-abdominal traumatism during childhood. The aim of this paper is to emphasize that the diagnosis can now be performed using only imaging techniques such as technetium-99 sulfur colloid or labelled heat-denatured red blood cell scintigraphy to avoid unnecessary invasive procedures including thoracotomy.

Thoracic Splenosis after Splenic and Diaphragmatic Injury / 대한흉부외과학회지

Thoracic splenosis is a rare disease that develops as a result of autotransplantation of splenic tissue into the thoracic cavity following splenic and diaphragmatic injury. We report the case of a 53-year-old man with a chief complaint of heartburn and cough. He had a history of traumatic diaphragmatic rupture treated with surgical repair and splenectomy 15 years ago. Imaging studies revealed a paraesophageal mass, and surgical resection was performed considering the possibility of Castleman disease or an esophageal submucosal tumor. Pathologic results showed findings of normal splenic tissue. The patient was discharged on postoperative day 5 without any complications.

Esplenosis abdominopélvica: Presentación de un caso y revisión de la literatura / Abdominopelvic Splenosis. Case Report and Literature Review

La esplenosis abdominal es el autotrasplante de tejido esplénico en la cavidad peritoneal en pacientes con antecedente de lesión traumática esplénica o esplenectomía. Es una condición asintomática y benigna que se diagnostica de forma incidental en estudios de imágenes o en cirugía. Las manifestaciones imaginológicas de la entidad generalmente se interpretan de manera equivocada como neoplasia secundaria. Presentamos un paciente con múltiples nódulos intraabdominales en tomografía computarizada (TC) de abdomen, secundarios a esplenosis abdominopélvica

Abdominal splenosis is the autotransplant of splenic tissue in the peritoneal cavity in patients with history of traumatic splenic injury and/or splenectomy. It is an asymptomatic and benign condition that is incidentally diagnosed in imaging studies or surgery. Imaging manifestations of this entity are generally misinterpreted as secondary neoplasia. We present a patient with multiple nodules in computed tomography (CT) of the abdomen, secondary to abdominopelvic splenosis.

Splenosis Mimicking Recurrence of Renal Cell Carcinoma after Radical Nephrectomy: A Case Report

Splenosis refers to the heterotropic autotransplantation of splenic tissue. Sometimes splenosis after surgical resection is difficult to differentiate from recurrence or metastasis of cancer. A 49-year-old male patient was diagnosed with clear cell renal cell carcinoma of left kidney. As there was no evidence of metastasis, he underwent radical nephrectomy with splenectomy. On surveillance computed tomography, masses at nephrectomy site and pleura were found and both were initially considered to be recurrence. After several cycle of pazopanib administration, pleural mass decreased in size while mass at nephrectomy site did not respond at all. Spleen scan showed increased uptake of the mass and therefore the mass was revealed to be splenosis. To avoid unnecessary treatment and planning optimal treatment, considering the possibility of splenosis is important and spleen scan can be helpful.

Laparoscopic management of pelvic splenosis

Splenosis is defined as heterotopic autotransplantation of spleen tissue following traumatic rupture of the spleen, or surgery. It is a benign disease that is generally without any symptoms and is discovered incidentally. Surgical intervention is recommended if symptoms are present. We report the successful laparoscopic management of a 49-year-old Korean woman with splenosis-associated symptoms who had undergone splenectomy.

Thoracic Splenosis: A Case Report and Noninvasive Diagnosis

Thoracic splenosis is an autotransplantation of splenic tissue to thorax resulting from splenic and diaphragmatic injury. Thoracic splenosis is usually discovered incidentally on routine thoracic imaging as single or multiple left-sided pleural-based masses without symptoms. Traditionally, patients often undergo an invasive diagnostic procedures including thoracotomy to acquire tissue samples in order to exclude other causes of lung mass. The combination of imaging findings and clinical history make it avoid unnecessary invasive diagnostic procedure to confirm. Therefore, thoracic splenosis should be considered in the differential diagnosis of asymptomatic patients with multiple, left-sided pleural-based nodules and previous history of thoracoabdominal injury and splenectomy. Here we report a case of thoracic splenosis diagnosed without invasive procedure.

PANCREATIC SPLENOSIS MIMICKING NEUROENDOCRINE TUMORS: microhistological diagnosis by endoscopic ultrasound guided fine needle aspiration

Context Pancreatic splenosis is a benign condition which can mimic a pancreatic neoplasm. Objective To describe the role of the endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) of pancreatic nodules suspicious for pancreatic splenosis. Method From 1997 to 2011, patients with pancreatic solid tumors suspicious for splenosis by computed tomography and/or magnetic resonance imaging were referred to EUS-FNA. Those cases with pancreatic splenosis confirmed by EUS-FNA or surgery were included. Endosonographic findings and clinicopathologic features were also analysed. Results A total of 2,060 patients with pancreatic solid tumors underwent EUS-FNA. Fourteen (0.6%) cases with pancreatic splenosis were found. After applying exclusion criteria, 11 patients were selected. Most patients were male (7), young (mean age: 42 years) and asymptomatic (8). Endoscopic ultrasound imaging alone suspected pancreatic splenosis in 6 cases, and neuroendocrine tumors in 5 cases. Pancreatic splenosis was found most commonly in the tail, was round, hypoechoic, with homogeneous pattern, regular borders, and with scintigraphy negative for somatostatin receptors. The average diameter of these nodules identified by endoscopic ultrasound was 2.15 cm. Microhistology obtained by EUS-FNA confirmed the diagnosis in 9/10 patients. Conclusion Pancreatic splenosis can be diagnosed by EUS-FNA. Microhistology prevents unnecessary surgeries, and reassures asymptomatic patients with hypoechoic, homogeneous, and well circumscribed pancreatic nodules. .

Contexto A esplenose pancreática é uma afecção benigna que pode mimetizar uma neoplasia pancreática. Objetivo Descrever o papel da ecoendoscopia associada à punção aspirativa com agulha fina ecoguiada (EE-PAAF) dos nódulos de pâncreas suspeitos de esplenose pancreática. Método De 1997 a 2011, pacientes com tumores sólidos de pâncreas sugestivos de esplenose pancreática, conforme achados de exames de imagem por tomografia computadorizada e/ou ressonância magnética foram encaminhados para EE-PAAF. Os casos com esplenose pancreática confirmada pela ecoendoscopia ou pela cirurgia foram incluídos. Os achados endossonográficos e os aspectos clinicopatológicos foram analisados. Resultados Dois mil e sessenta pacientes com tumores sólidos do pâncreas foram submetidos a EE-PAAF. Quatorze (0,6%) casos com esplenose pancreática foram encontrados. Após emprego dos critérios de exclusão, 11 pacientes foram selecionados. A maioria dos pacientes era do sexo masculino (7), jovens (idade média: 42 anos) e assintomáticos (8). A imagem ecoendoscópica isolada suspeitou de esplenose pancreática em 6 casos, e tumores neuroendócrinos em outros 5 casos. A esplenose pancreática foi detectada mais comumente na cauda do pâncreas, era redonda, hipoecogênica, com padrão homogêneo, bordos regulares bem delimitados e com cintilografia negativa para os receptores de somatostatina. O diâmetro médio dos nódulos foi de 2,15 cm. A microhistologia obtida pela EE-PAAF confirmou o diagnóstico em 9/10 pacientes. Conclusão A esplenose pancreática pode ser diagnosticada pela punção aspirativa com agulha fina ecoguiada. A microhistologia evita cirurgias desnecessárias ...

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

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.

Intrahepatic Splenosis Mimicking Liver Metastasis in a Patient with Gastric Cancer

A 54 year old man was referred to our hospital with gastric cancer. The patient had a history of splenectomy and a left nephrectomy as a result of a traffic accident 15 years earlier. The endoscopic findings were advanced gastric cancer at the lower body of the stomach. Abdominal ultrasonography (USG) and magnetic resonance imaging demonstrated a metastatic nodule in the S2 segment of the liver. Eventually, the clinical stage was determined to be cT2cN1cM1 and a radical distal gastrectomy, lateral segmentectomy of the liver were performed. The histopathology findings confirmed the diagnosis of intrahepatic splenosis, omental splenosis. Hepatic splenosis is not rare in patients with a history of splenic trauma or splenectomy. Nevertheless, this is the first report describing a patient with gastric cancer and intrahepatic splenosis that was misinterpreted as a liver metastatic nodule. Intra-operative USG guided fine needle aspiration should be considered to avoid unnecessary liver resections in patients with a suspicious hepatic metastasis.

Thoracic Splenosis: A Case Report and the Importance of Clinical History

We present a case of thoracic splenosis in a 42-yr-old man with a medical history of abdominal surgery for a penetration injury with an iron bar of the left abdomen and back. He had been in good condition, but a chest radiograph taken during a regular checkup showed a multinodular left pleura-based mass. Computed tomography (CT) showed that the mass was well-enhanced and homogeneous, indicating a sclerosing hemangioma. Following its removal by video-assisted thoracoscopic surgery, the mass appeared similar to a hemangioma, with marked adhesion to the left side diaphragmatic pleura and lung parenchyma. Frozen section showed that the lesion was a solid mass consisted with abundant lymphoid cells, suggesting a low grade lymphoma. On permanent section, however, the mass was found to be composed of white pulp, red pulp, a thick capsule and trabeculae and was diagnosed as ectopic splenic tissue, or thoracic splenosis. Review of the patient's history and chest CT at admission revealed that the patient had undergone a splenectomy for the penetration injury 20 yr previously.

Hepatic Splenosis Preoperatively Diagnosed as Hepatocellular Carcinoma in a Patient with Chronic Hepatitis B: A Case Report

We report on a case of hepatic splenosis. A 32-yr-old man underwent a splenectomy due to trauma at the age of 6. He had been diagnosed as being a chronic hepatitis B-virus carrier 16 yr prior to the surgery. The dynamic computer tomography (CT) performed due to elevated serum alpha-fetoprotein (128 ng/mL) demonstrated two hepatic nodules, which were located near the liver capsule. A nodule in Segment IVa had a slight enhancement during both the arterial and portal phases, and another nodule in Segment VI showed a slight enhancement only in the portal phases. Dynamic magnetic resonance imaging (MRI) of the mass in Segment VI showed enhanced development in the arterial phases and slight hyperintensivity to the liver parenchyma in the portal phases. These imaging findings suggested a hypervascular tumor in the liver, which could be either focal nodular hyperplasia, adenoma, or hepatocellular carcinoma (HCC). Even though these lesions were diagnosed as HCC, some of the findings were not compatible with typical HCC. On dynamic CT and MRI, all lesions showed a slight arterial enhancement and did not show early venous washout. All lesions were located near the liver capsule. These findings, along with a history of splenectomy, suggested a diagnosis of hepatic splenosis.

Case of Colonic Polyps with Abdominal Splenosis Mimicking Carcinomatosis / 대한내과학회지

Splenosis is an ectopic implantation of splenic tissue after splenic injury or splenectomy. These splenic implants may be located throughout the abdominal cavity and may be misdiagnosed as a malignancy or tumorous condition. Here, we report a case of splenosis that was initially diagnosed as carcinomatosis from colon cancer in a patient with colon polyps that had undergone explo-laparotomy.

Multifocal Peritoneal Splenosis in Tc-99m-Labeled Heat-Denatured Red Blood Cell Scintigraphy / 핵의학분자영상

A 44-year-old man with a past medical history of splenectomy came to hospital because of epigastric pain. Abdominopelvic computed tomography(CT) showed a soft tissue mass and multifocal variable-sized nodules as well as findings suggestive of cholecystitis. Subsequently, he underwent Tc-99m-labeled heat-denatured red blood cell(RBC) scintigraphy to evaluate the mass and nodules. The scintigraphy confirmed multifocal peritoneal splenosis in the abdominopelvic cavity.

A case of pelvic splenosis after splenectomy: A cause of pelvic pain / 대한산부인과학회지

Splenosis represents the autotransplantation of splenic tissue, after splenic trauma or surgery. These splenic implants may be located anywhere in the abdominal cavity. These implants may misinterpreted as endometriosis or malignancy. We present a case of multiple pelvic splenic implants after a splenectomy.

Splenosis Mimicking Carcinomatosis Peritonei in Advanced Gastric Cancer

Splenosis is the autotransplantation of fragmented splenic tissue that occurs as a result of traumatic splenic rupture or a routine splenectomy. Generally, splenic implants are numerous and located within the peritoneal cavity; peritoneum, omentum and abdominal viscera, and occasionally on extra-abdominal surfaces. Splenic implants are rarely clinically significant and are incidental found during an abdominal operation, but occasionally mimics primary or metastatic tumors, as seen on radiological studies. Herein, the case of a patient in whom multiple abdominal masses were identified as splenosis, but the initial radiographic finding was that of carcinomatosis peritonei.

Splenosis with Cyclic Abdominal Pain Misdiagnosed as Ovarian Dermoid Cyst

Splenosis is defined as the autotransplantation of splenic tissue after a traumatic splenic injury or a splenectomy. It has often been mistaken as an endometriosis, an intraperitoneal carcinoma, a hemangioma and an accessory spleen. It is clinically significant in that it requires no treatment if it is asymptomatic. Here we report a case of 34 year-old woman who had a pelvic splenosis with cyclic abdominal pain for several years, which was initially misdiagnosed as ovarian dermoid cyst. At the time of exploration, a splenosis was observed in the pelvic cavity. After surgery, a multiple splenosis in the abdominal cavity was found through a Tc-99m heat denatured red blood cell scan. The removal of the splenosis in the pelvic cavity resulted in an improvement in her symptoms.

Protein and C_(3b) Fc receptor expression of the macrophage in autotranspla ntated splenictissue / 中国普通外科杂志

Objective To investigate the f un ction of the autotransplanted splenic tissue. Method s 120 Kunming mice were randomly divided into two groups: sham operation group and group of 50% autograft splenic tissue implantation in the om ental pouch after total splenectomy. Six months after, splenic transplants were removed, and C 3b and Fc receptor and the expression of protein on the macr ophages was assayed in the implanted splenic tissue. Results The expression of protein and the receptor on the mac rophage in transplants were similar with that in the normal group. Conclusion The function of the macrophages in t he implanted splenic tissue judged by the expression of protein and receptor is normal, the autotransplanted splenic tissue can fulfil the function of the norma l spleen.