Type:
Educational Exhibit
Keywords:
Trauma, Tissue characterisation, Imaging sequences, Contrast agent-intravenous, Nuclear medicine conventional, MR, CT, Spleen, Gastrointestinal tract, Abdomen
Authors:
G. Porrello; Palermo/IT
DOI:
10.26044/ecr2019/C-1320
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 filtering functions,
making splenosis beneficial for the organism[2].
For these reasons,
preoperative diagnosis is desirable.
However,
splenosis is rarely encountered and not often thought of.
Although extremely rare,
compared to neoplastic lesions,
the diagnosis of splenosis must be taken into account in all patients with history of splenic trauma presenting with an isolated,
intra-parenchymatous lesion or multiple intra-abdominal masses.
The most important principle is to have a high level of suspicion,
especially in patients with risk factors for malignant conditions.
In conclusion,
the characteristic imaging and enhancement patterns of splenic implants on MR and CT are identical to normal spleen,
making it an easy call -if known- for the abdominal radiologist.