Intrahepatic and Intra-abdominal Splenosis: A Case Report and Review of Literature

Overview

Journal World J Hepatol

Publisher Baishideng Publishing Group

Specialty Gastroenterology

Date 2020 Jan 23

PMID 31966909

Citations 3

Authors

Kiruthika Ananthan

Gibran Timothy Yusuf

Mayur Kumar

Affiliations

Soon will be listed here.

Abstract

Background: Splenosis is defined as the process by which tissue from the spleen disseminates through the body and grows in an ectopic location following trauma or a splenectomy. Visceral sites of splenosis are rare.

Case Summary: We report a case of intrahepatic splenosis in a 57-year-old man with a history of trauma over 40 years ago who initially presented with chest pain. Findings initially mimicked malignancy but a diagnosis of intrahepatic splenosis was confirmed using computed tomography and scintigraphy with technetium-99m heat-denatured red blood cells (Tc-99 DRBC).

Conclusion: Scintigraphy with Tc-99 DRBC is a reliable technique to diagnose splenosis and should be performed before using more invasive procedures are carried out. Splenosis should be considered as a possible differential diagnosis for a hepatic nodule in any patient with a history of abdominal trauma, previous splenectomy or atypical radiological features on imaging.

Citing Articles

Pelvic mass causing hematospermia: splenosis.

Jiang Y, Chen L, Wang M, Li X, Xie D, Yu D BMC Urol. 2022; 22(1):187.

PMID: 36384575 PMC: 9670433. DOI: 10.1186/s12894-022-01138-w.

Detection of Splenic Tissue Using Tc-Labelled Denatured Red Blood Cells Scintigraphy-A Quantitative Single Center Analysis.

Holzgreve A, Volter F, Delker A, Kunz W, Fabritius M, Brendel M Diagnostics (Basel). 2022; 12(2).

PMID: 35204576 PMC: 8871479. DOI: 10.3390/diagnostics12020486.

A case of hepatic splenosis in the setting of iron overload; multimodal and literature review.

Richardson L, Gardner K, Eberhardt S, Thompson W Radiol Case Rep. 2021; 16(9):2499-2504.

PMID: 34257788 PMC: 8259227. DOI: 10.1016/j.radcr.2021.05.037.

References

Wang M, Li B, Chen D, Liu A, Qamar S, Sun M . Spleen implanting in the fatty liver mimicking hepatocarcinoma in a patient with hepatitis B&C: A case report and literature review. Medicine (Baltimore). 2017; 96(25):e7217. PMC: 5484221. DOI: 10.1097/MD.0000000000007217. View

Massey M, Stevens J . Residual spleen found on denatured red blood cell scan following negative colloid scans. J Nucl Med. 1991; 32(12):2286-7. View

Guedes T, Fernandes B, Pedroto I . Hepatobiliary and Pancreatic: Symptomatic hepatic splenosis. J Gastroenterol Hepatol. 2019; 34(12):2061. DOI: 10.1111/jgh.14743. View

Xuan Z, Chen J, Song P, Du Y, Wang L, Wan D . Management of intrahepatic splenosis:a case report and review of the literature. World J Surg Oncol. 2018; 16(1):119. PMC: 6022698. DOI: 10.1186/s12957-018-1419-1. View

Li T, Yang X, Tang Z . Intrahepatic and intraperitoneal splenosis mimicking hepatocellular carcinoma with abdominal wall metastasis in a patient with hepatitis C cirrhotic liver. Surgery. 2015; 157(5):954-6. DOI: 10.1016/j.surg.2013.12.018. View

Yu H, Xia L, Li T, Ju M, Liu L, Wu Z . Intrahepatic splenosis mimicking hepatoma. BMJ Case Rep. 2011; 2009. PMC: 3029048. DOI: 10.1136/bcr.06.2008.0230. View

Ksiadzyna D . A case report of abdominal splenosis - a practical mini-review for a gastroenterologist. J Gastrointestin Liver Dis. 2011; 20(3):321-4. View

Basile R, Morales J, Zupanec R . Splenosis. A cause of massive gastrointestinal hemorrhage. Arch Surg. 1989; 124(9):1087-9. DOI: 10.1001/archsurg.1989.01410090097022. View

Page J, Lenz D, Wong C . Right-sided intrarenal splenosis mimicking a renal carcinoma. ScientificWorldJournal. 2007; 6:2442-4. PMC: 5917350. DOI: 10.1100/tsw.2006.380. View

10.

Arena R, Gasperoni S, Lisotti A, Petrini C, Brancaccio M, Triossi O . An unusual cause of gastrointestinal bleeding and intestinal obstruction. Turk J Gastroenterol. 2018; 29(3):365-366. PMC: 6284667. DOI: 10.5152/tjg.2018.17647. View

11.

Sato N, Abe T, Suzuki N, Waragai M, Teranishi Y, Takano Y . Intrahepatic splenosis in a chronic hepatitis C patient with no history of splenic trauma mimicking hepatocellular carcinoma. Am J Case Rep. 2014; 15:416-20. PMC: 4179547. DOI: 10.12659/AJCR.890999. View

12.

Inchingolo R, Peddu P, Karani J . Hepatic splenosis presenting as arterialised liver lesion in a patient with NASH. Eur Rev Med Pharmacol Sci. 2013; 17(21):2853-6. View

13.

Sica G, Ji H, Ros P . CT and MR imaging of hepatic metastases. AJR Am J Roentgenol. 2000; 174(3):691-8. DOI: 10.2214/ajr.174.3.1740691. View

14.

Bastidas A, Holloman D, Lankarani A, Nieto J . Endoscopic Ultrasound-Guided Needle-Based Probe Confocal Laser Endomicroscopy (nCLE) of Intrapancreatic Ectopic Spleen. ACG Case Rep J. 2016; 3(3):196-8. PMC: 4843155. DOI: 10.14309/crj.2016.48. View

15.

El-Kheir A, Abdelnour M, Boutros J . Simultaneous small bowel and colon obstruction due to splenosis. A case report and review of literature. Int J Surg Case Rep. 2019; 58:63-66. PMC: 6479103. DOI: 10.1016/j.ijscr.2019.03.040. View

16.

Mortele K, Praet M, Van Vlierberghe H, KUNNEN M, Ros P . CT and MR imaging findings in focal nodular hyperplasia of the liver: radiologic-pathologic correlation. AJR Am J Roentgenol. 2000; 175(3):687-92. DOI: 10.2214/ajr.175.3.1750687. View

17.

Kim J, Lee S, Choi J, Lyu J, Lee M . Two Rare Cases of Intrathoracic Splenosis and Subcutaneous Splenosis: Spleen Scintigraphy Avoided the Need for Invasive Procedures. Nucl Med Mol Imaging. 2016; 50(1):76-9. PMC: 4762861. DOI: 10.1007/s13139-015-0370-0. View

18.

De Vuysere S, Van Steenbergen W, Aerts R, Van Hauwaert H, Van Beckevoort D, Van Hoe L . Intrahepatic splenosis: imaging features. Abdom Imaging. 2000; 25(2):187-9. DOI: 10.1007/s002619910042. View

19.

Choi J, Lee J, Sirlin C . CT and MR imaging diagnosis and staging of hepatocellular carcinoma: part I. Development, growth, and spread: key pathologic and imaging aspects. Radiology. 2014; 272(3):635-54. PMC: 4263631. DOI: 10.1148/radiol.14132361. View

20.

Faria S, Iyer R, Rashid A, Whitman G . Hepatic adenoma. AJR Am J Roentgenol. 2004; 182(6):1520. DOI: 10.2214/ajr.182.6.1821520. View