Learning objectives
To easily recognize splenosis and make a correct differential diagnosis with neoplastic diseases.
Background
The term “splenosis” was first defined by Buchbinder and Lipkopf in 1939[1].
It is a rare,
benign,
acquired condition,
defined as the auto-transplantation of splenic tissue in a heterotopic location.
It arises in patients who underwent a splenic rupture or removal and results from the spillage of cells from the damaged pulp of the spleen in nearby body cavities[2].
Splenosis has been reported to occur in up to 67% of patients who have had splenic trauma[3],
even though the real incidence is unknown,
since it...
Findings and procedure details
Splenic implants have irregular architecture with a poorly formed capsule[3],
are small in size (< 3 cm)[11] and generally asymptomatic[4].
They can be solitary or multiple (up to 400 nodules)[11] and may slowly grow over time (up to 12 cm)[10].
For these characteristics,
the differential diagnosis includes abdominal malignancies,
metastatic disease,
lymphoma and carcinomatosis[2].
A definitive preoperative diagnosis requires a high index of suspicion and should be established cautiously: a detailed medical history,
as well as correlation with physical examination and laboratory tests,
is necessary[3;...
Conclusion
Splenosis can be localized virtually everywhere inside the body.
A missed diagnosis has a negative influence on a patient’s management[2] since it leads to difficult and unnecessary treatments,
such as biopsies,
angiography,
surgery or chemotherapy.
Presumed diagnosis can be made with CT and MRI and can be supported by laboratory analysis.
Scintigraphy with heat-damaged red blood cells represents the best test to confirm the diagnosis. Since splenic nodules are made of normal functioning splenic tissue,
many researchers suggested that they might have immunologic values and...
Personal information
Dr.
Giorgia Porrello
e-mail:
[email protected]
Resident in training,
Scuola di Specializzazione in Radiodiagnostica
Università degli Studi di Palermo,
Policlinico "Paolo Giaccone",
Di.Bi.Med.
Via del Vespro,
129,
Palermo
Italy
References
1.
Buchbinder JH,
Lipkoff CJ,
“Splenosis: multiple peritoneal splenic implants following abdominal injury”,
Surgery 6:927–934,
1939.
2.
Doriana Vergara,
Francesco Ginolfi,
Stefano Moscati,
Beniamino Giordano,
Nicola Ferrara,
Camilla Panico and Massimo Imbriaco,
“Multiple intra-hepatic and abdominal splenosis: an easy call if you know about it”,
Acta Radiologica Open 7(5) 1–4,
The Foundation Acta Radiologica,
2018.
DOI: 10.1177/2058460118772324
3.
Yasmeen K.
Tandon,
Christopher P.
Coppa,
Andrei S.
Purysko,
“Splenosis: a great mimicker of neoplastic disease”,
Abdom Radiol (2018) DOI: 10.1007/s00261-018-1601-5
4.
Michael D’angelica,
Yuman Fong and...