Imaging of intra-adbominal splenosis: what the radiologist needs to know

Congress:

ECR 2019

Poster Number:

C-3201

Type:

Educational Exhibit

Keywords:

Diagnostic procedure, MR, CT, Spleen, Abdomen, Trauma

Authors:

M. Dimarco¹, V. Putortì¹, F. Arnone², R. Cannella¹, D. Giambelluca¹, M. Midiri¹; ¹Palermo/IT, ²Partinico/IT

DOI:

10.26044/ecr2019/C-3201

DOI-Link:

https://dx.doi.org/10.26044/ecr2019/C-3201

Fig. 1: Fig 1. Axial scans of a 68-year-old woman performed for "suspected pancreatic...

Fig. 2: Fig. 2: Axial CT scans performed in the non-contrast (A), arterial (B) and...

Fig. 3: Fig 3 Axial scans, acquired on portal-venous phase, of a 65-year-old man with...

Fig. 4: Fig 4. Axial scans of a 50-year-old patient performing MRI for evaluation of a...

Learning objectives

To discuss the main imaging features of intra-abdominal splenosis.

Background

The term "splenosis" refers to an uncommon, benign, acquired condition of heterotopic autotransplantation of splenic tissue in another anatomic compartment of the body. This condition is more frequently found in patients subsequent to major abdominal trauma with splenic rupture, laceration or splenectomy. Splenosis must be distinguished from the accessory spleen, a more frequently encountered congenital condition. Often asymptomatic, splenosis may be seen as an incidental finding; rarely it can present a vague and non-specific symptomatology, due mainly to the increase in size of the nodules....

Findings and procedure details

Imaging can be useful for the detection and differential diagnosis of splenosis. Patient history should take into account abdominal surgery or prior splenic trauma. Sometimes, splenosis nodules can be discovered as incidental findings during an US or CT exam performed for other reasons. The diagnostic procedure may be integrated by using contrast-enhanced CT and MRI to reach a correct diagnosis. On CT, splenosis nodules may be rounded or sessile, with similar density and contrast enhancement of the spleen [2,3]. Like their appearance on CT, even...

Conclusion

Although splenosis is a rare and asymptomatic condition, its diagnosis may be challenging for the radiologist. It is crucial, along with full patient history, to know its imaging features, in order to provide a correct differential diagnosis with other benign and malignant intraperitoneal lesions (ranging from endometriosis to peritoneal carcinomatosis).

Personal information

References

1. Spencer T. Lake,Pamela T. Johnson,Satomi Kawamoto,Ralph H. HrubanandElliot K. Fishman CT of Splenosis: Patterns and Pitfalls AJR Am J Roentgenol.2012 Dec;199(6):W686-93. doi: 10.2214/AJR.11.7896. 2. Tsitouridis I, Michaelides M, Sotiriadis C, Arvaniti M. CT and MRI of intraperitoneal splenosis.Diagn Interv Radiol2010; 16:145–149 3. Wen-Chiung Lin et al. MR Features of Abdominal Splenosis 2003 American Journal of Roentgenology. 2003;180: 493-496. 10.2214/ajr.180.2.1800493 4. Akay S, Ilica AT, Battal B, Karaman B, Guvenc I. Pararectal mass: an atypical location of splenosis.J Clin Ultrasound2011 May 27