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Li X, Hu X, Wang P, Hu G, Zhou B, Cai J. A large gastric splenosis mimicking gastrointestinal stromal tumor: A case report and literature review. Exp Ther Med 2024; 27:186. [PMID: 38533436 PMCID: PMC10964733 DOI: 10.3892/etm.2024.12474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Accepted: 02/13/2024] [Indexed: 03/28/2024] Open
Abstract
Splenosis pertains to the phenomenon wherein a segment of the spleen undergoes detachment and becomes embedded in other anatomical regions subsequent to traumatic rupture or therapeutic resection, and then progressively establishing blood circulation to foster the regeneration of splenic tissue. Existing literature posits that splenosis predominantly manifests within the confines of the abdominal and pelvic cavities. The objective of the current study was to present an uncommon case involving the occurrence of splenosis within the gastric myometrium, thereby contributing to the current knowledge regarding splenosis. A 16-year-old female sought medical assistance owing to recurrent abdominal pain persisting for a duration of six months, and had a history of splenectomy two years prior. Gastroscopy, endoscopic ultrasound and computed tomography (CT) examination collectively identified a lesion in the submucosal prominence of the fundus of the stomach. Initial considerations based on imaging examinations leaned towards a gastrointestinal stromal tumor. Consequently, an endoscopic resection was undertaken. Remarkably, the pathological findings and histochemistry concurred with the alterations associated with ectopic spleen implantation, leading to a stable postoperative course. In conclusion, splenosis denotes the implantation of a segment of the spleen into extraneous anatomical sites, attributable to traumatic rupture or therapeutic resection. The preoperative diagnosis of splenosis can pose a challenge, potentially culminating in unnecessary radical clinical interventions. Therefore, the acquisition of a comprehensive medical history, with a particular focus on surgical and trauma events, emerges as pivotal for an accurate diagnosis. In light of novel diagnostic modalities, the non-invasive technology of nuclear medicine can efficaciously visualize ectopic splenic tissue, thereby averting superfluous surgical procedures. It is both feasible and imperative to implement individualized treatment strategies for patients afflicted with splenosis.
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Affiliation(s)
- Xiaotian Li
- Department of Nuclear Medicine, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou 563000, P.R. China
- Department of Nuclear Medicine, People's Hospital of Qianxinan Buyi and Miao Minority Autonomous Prefecture, Xingyi, Guizhou 562400, P.R. China
| | - Xianwen Hu
- Department of Nuclear Medicine, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou 563000, P.R. China
| | - Pan Wang
- Department of Nuclear Medicine, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou 563000, P.R. China
| | - Guiyun Hu
- Department of Nuclear Medicine, People's Hospital of Qianxinan Buyi and Miao Minority Autonomous Prefecture, Xingyi, Guizhou 562400, P.R. China
| | - Bin Zhou
- Department of Nuclear Medicine, People's Hospital of Qianxinan Buyi and Miao Minority Autonomous Prefecture, Xingyi, Guizhou 562400, P.R. China
| | - Jiong Cai
- Department of Nuclear Medicine, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou 563000, P.R. China
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Liu Y, Dai Y, Xiao F, Liu S, Wu Y, Ran E. Rare case of upper gastrointestinal hemorrhage due to accessory spleen: A case report. Medicine (Baltimore) 2022; 101:e29636. [PMID: 35945721 PMCID: PMC9351849 DOI: 10.1097/md.0000000000029636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
RATIONALE Upper gastrointestinal hemorrhage (UGIH) is defined as hemorrhage originating from the gastrointestinal tract proximal to the ligament of Treitz. The causes of UGIH include esophagitis, gastritis, peptic ulcers, Mallory-Weiss syndrome, and cancer. However, a rare cause of UGIH, such as an accessory spleen, may lead to serious complications if left untreated and can sometimes be very difficult to diagnose preoperatively. PATIENT CONCERNS An 18-year-old man was admitted to the Department of Gastroenterology of our hospital due to "repeated black stool for 2 months with aggravation, accompanied by hematemesis for 9 days." He denied any history of hepatitis, trauma, or surgery. DIAGNOSIS Laboratory evaluation revealed severe anemia (hemoglobin, 6.4 g/dL). Computed tomography revealed a mass measuring 127 mm in its largest dimension, located in the upper left abdomen, with varicose veins in the gastric fundus. Moreover, distended blue-purple tortuous veins were observed by gastroscopy in the gastric fundus. We believed the mass was likely an abnormally proliferating accessory spleen; however, the causes of severe anemia and gastrointestinal hemorrhage were unknown. INTERVENTIONS After discussion in a multidisciplinary conference, the mass was completely resected laparoscopically, and the subserosal veins in the gastric fundus were sutured using absorbable threads. OUTCOMES After the surgery, the patient recovered uneventfully without any complications. Clinicopathological examination showed that the mass was chronic congestive splenomegaly. Gastrointestinal hemorrhage secondary to an abnormally proliferating accessory spleen was confirmed as the diagnosis. Laboratory evaluation revealed hemoglobin at 12.1 g/dL 2 months after surgery. At the 12-month follow-up, the patient showed no recurrence of gastrointestinal hemorrhage. LESSONS UGIH caused by accessory spleen is extremely rare. This entity should be considered in differential diagnosis of gastrointestinal hemorrhage. Surgical intervention is necessary for timely diagnosis and treatment in case of gastrointestinal hemorrhage in critical clinical situations.
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Affiliation(s)
- Yuanjun Liu
- Department of Hepatobiliary Surgery, Suining Central Hospital, Suining, Sichuan Province, China
| | - Yi Dai
- Department of Hepatobiliary Surgery, Suining Central Hospital, Suining, Sichuan Province, China
| | - Fan Xiao
- Department of Hepatobiliary Surgery, Suining Central Hospital, Suining, Sichuan Province, China
| | - Shuang Liu
- Department of Hepatobiliary Surgery, Suining Central Hospital, Suining, Sichuan Province, China
| | - Yakun Wu
- Department of Hepatobiliary Surgery, Suining Central Hospital, Suining, Sichuan Province, China
| | - Enrong Ran
- Department of Nephrology, Suining Central Hospital, Suining, Sichuan Province, China
- *Correspondence: Enrong Ran, Department of Nephrology, Suining Central Hospital, Suining 629000, China (e-mail: )
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3
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Rompou V, Korkolis D, Skafida E, Tsamis D, Plastiras A. Splenosis mimicking gastric obstructive tumor: Diagnostic workup and surgical excision. Clin Case Rep 2021; 9:e05225. [PMID: 34963809 PMCID: PMC8710848 DOI: 10.1002/ccr3.5225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Revised: 11/01/2021] [Accepted: 12/03/2021] [Indexed: 11/30/2022] Open
Abstract
Splenosis is a condition that occurs after splenic rupture. A 29-year-old male patient with a history of splenectomy was admitted due to multiple vomiting episodes. The diagnostic workup was unable to differentiate between gastric GIST and splenosis. Laparoscopic surgical resection was performed leading to the diagnosis of splenosis.
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Affiliation(s)
- Vaia‐Aliki Rompou
- Department of Surgical OncologySt Savvas Oncological CentreAthensGreece
| | | | - Evelina Skafida
- Department of Histopathology LaboratorySt Savvas Oncological CentreAthensGreece
| | | | - Aris Plastiras
- Department of Surgical OncologySt Savvas Oncological CentreAthensGreece
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Braun T, De Gregorio A, Baumann L, Steinacker J, Janni W, De Gregorio N. Coincidence of Intra-Abdominal Splenosis in a Patient with Advanced Ovarian Cancer: Case Report and Review of the Literature. Surg J (N Y) 2021; 7:e116-e120. [PMID: 34179460 PMCID: PMC8221843 DOI: 10.1055/s-0041-1731426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Accepted: 03/25/2021] [Indexed: 11/27/2022] Open
Abstract
Splenosis is a rare disease, which is often discovered incidentally years after surgical procedures on the spleen or traumatic splenic lesions. Through injury of the splenic capsule, splenic cells are able to spread and autoimplant in a fashion similar to the process of metastatic cancer. Here we present the case of a 62-year-old female patient with a palpable tumor of the lower abdomen. Her medical history was unremarkable, except for splenectomy after traumatic splenic lesion in her childhood. Clinical examination and diagnostic imaging raised the suspicion of advanced ovarian cancer, which was further substantiated by the typical presentation of adnexal masses and disseminated peritoneal metastases during the following staging laparotomy. Surprisingly, we also found peritoneal implants macroscopically similar to splenic tissue. Microscopic examination of tissue specimens by intrasurgical frozen section confirmed the diagnosis of intra-abdominal splenosis. The patient then underwent cytoreductive surgery with complete resection of all cancer manifestations, sparing the remaining foci of splenosis to avoid further morbidity. This case demonstrates the rare coincidence of intra-abdominal carcinoma and splenosis, which could lead to intraoperative difficulties by misinterpreting benign splenic tissue. Therefore, splenosis should be considered in patients with medical history of splenic lesions and further diagnostic imaging like Tc-99m-tagged heat-damaged RBC scan could be used for presurgical distinguishing between tumor spread in the abdominal cavity and disseminated splenosis. The presented case report should not only raise awareness for the rare disease splenosis, but also emphasize the need to consider the possibility of simultaneous incidence of benign and malignant intra-abdominal lesions, as to our knowledge this is the first published case of simultaneous peritoneal carcinomatosis and splenosis.
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Affiliation(s)
- Tatjana Braun
- Department of Gynecology and Obstetrics, University Hospital Ulm, Ulm, Germany
| | - Amelie De Gregorio
- Department of Gynecology and Obstetrics, University Hospital Ulm, Ulm, Germany
| | - Lisa Baumann
- Department of Pathology, University Hospital Ulm, Ulm, Germany
| | - Jochen Steinacker
- Department of Diagnostic and Interventional Radiology, University Hospital Ulm, Ulm, Germany
| | - Wolfgang Janni
- Department of Gynecology and Obstetrics, University Hospital Ulm, Ulm, Germany
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Zhang J, Zhong JW, Lu GR, Zhou YH, Xue ZX, Ye MS. Accessory spleen originating from the intrinsic muscularis of the stomach misdiagnosed as gastrointestinal stromal tumor: a case report. J Int Med Res 2021; 48:300060520935304. [PMID: 32762474 PMCID: PMC7416145 DOI: 10.1177/0300060520935304] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
A 34-year-old man presented to our hospital with a 2-month history of repeated dull upper
abdominal pain. Gastroscopy and endoscopic ultrasonography indicated a hemispherical mass
at the junction of the greater curvature and the gastric fundus, with hypoechogenicity
originating from the intrinsic muscular layer. He was diagnosed with a gastric body
submucosal lesion and gastrointestinal stromal tumor, and underwent endoscopic
full-thickness resection. However, postoperative pathological examination of the mass
unexpectedly revealed heterotopic spleen tissue (accessory spleen). Intragastric ectopic
spleen tissue originating from the intrinsic muscular layer of the stomach is a rare
clinical condition, with no specific clinical symptoms. This finding is of great clinical
significance for the identification of gastric submucosal tumors.
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Affiliation(s)
- Jing Zhang
- Department of Gastroenterology, Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Jin-Wei Zhong
- Department of Gastroenterology, Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Guang-Rong Lu
- Department of Gastroenterology, Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Yu-Hui Zhou
- Department of Gastroenterology, Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Zhan-Xiong Xue
- Department of Gastroenterology, Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Meng-Si Ye
- Department of Gastroenterology, Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
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Kanagalingam G, Vyas V, Sostre V, Arif MO. Gastric Splenosis Mimicking Gastrointestinal Stromal Tumor. Cureus 2021; 13:e12816. [PMID: 33628682 PMCID: PMC7894967 DOI: 10.7759/cureus.12816] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/20/2021] [Indexed: 02/05/2023] Open
Abstract
Translocation of splenic tissue in patients after traumatic spleen injury or splenectomy is called splenosis. Gastric splenosis is a rare presentation that can be mistaken for gastrointestinal stromal tumor (GIST). Patients are usually asymptomatic and do not require surgical intervention. In this report, we present a case of a 68-year-old male patient with a previous history of surgical splenectomy after traumatic splenic rupture, who underwent routine upper endoscopy for the evaluation of dysphagia. An endoscopic exam of the stomach revealed an incidental finding of a submucosal gastric nodule. On endoscopic ultrasound exam, the lesion was found to be suggestive of GIST originating from layer 4. A core biopsy was obtained from the nodule, which was consistent with gastric splenosis. The differentiation of gastric splenosis from other gastric lesions such as GIST is important since asymptomatic patients with gastric splenosis do not need to undergo surveillance or surgical resection. It should be suspected especially in patients with a history of splenectomy or splenic rupture. Endoscopic ultrasound (EUS)-guided core biopsy can help confirm the diagnosis and differentiate the condition from GIST.
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Affiliation(s)
| | - Vrinda Vyas
- Department of Internal Medicine, Upstate University Hospital, Syracuse, USA
| | - Vanessa Sostre
- Department of Gastroenterology, Upstate University Hospital, Syracuse, USA
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Splenosis: An underappreciated cause of gastrointestinal bleeding in splenectomized patients. Case report and literature review. GASTROENTEROLOGIA Y HEPATOLOGIA 2020; 44:369-373. [PMID: 33172692 DOI: 10.1016/j.gastrohep.2020.08.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 07/14/2020] [Accepted: 08/25/2020] [Indexed: 11/24/2022]
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Isopi C, Vitali G, Pieri F, Solaini L, Ercolani G. Gastric splenosis mimicking a gastrointestinal stromal tumor: A case report. World J Gastrointest Surg 2020; 12:435-441. [PMID: 33194092 PMCID: PMC7642345 DOI: 10.4240/wjgs.v12.i10.435] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 08/13/2020] [Accepted: 09/14/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Mass lesions located in the wall of the stomach (and also of the bowel) are referred to as “intramural.” The differential diagnosis of such lesions can be challenging in some cases. As such, it may occur that an inconclusive fine needle aspiration (FNA) result give way to an unexpected diagnosis upon final surgical pathology. Herein, we present a case of an intramural gastric nodule mimicking a gastric gastrointestinal stromal tumor (GIST).
CASE SUMMARY A 47-year-old Caucasian woman, who had undergone splenectomy for trauma at the age of 16, underwent gastroscopy for long-lasting epigastric pain and dyspepsia. It revealed a 15 mm submucosal nodule bulging into the gastric lumen with smooth margins and normal overlying mucosa. A thoraco-abdominal computed tomography scan showed in the gastric fundus a rounded mass (30 mm in diameter) with an exophytic growth and intense enhancement after administration of intravenous contrast. Endoscopic ultrasound scan showed a hypoechoic nodule, and fine needle FNA was inconclusive. Gastric GIST was considered the most probable diagnosis, and surgical resection was proposed due to symptoms. A laparoscopic gastric wedge resection was performed. The postoperative course was uneventful, and the patient was discharged on the seventh postoperative day. The final pathology report described a rounded encapsulated accumulation of lymphoid tissue of about 4 cm in diameter consistent with spleen parenchyma implanted during the previous splenectomy.
CONCLUSION Splenosis is a rare condition that should always be considered as a possible diagnosis in splenectomized patients who present with an intramural gastric nodule.
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Affiliation(s)
- Claudio Isopi
- Department of Surgery, Morgagni-Pierantoni Hospital, Forli 47121, Italy
| | - Giulia Vitali
- Department of Surgery, Morgagni-Pierantoni Hospital, Forli 47121, Italy
| | - Federica Pieri
- Pathology Unit, Morgagni-Pierantoni Hospital, Forli 47121, Italy
| | - Leonardo Solaini
- Department of Surgery, Morgagni-Pierantoni Hospital, Forli 47121, Italy
- Department of Medical and Surgical Sciences, University of Bologna, Bologna 47100, Italy
| | - Giorgio Ercolani
- Department of Surgery, Morgagni-Pierantoni Hospital, Forli 47121, Italy
- Department of Medical and Surgical Sciences, University of Bologna, Bologna 47100, Italy
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Vernuccio F, Dimarco M, Porrello G, Cannella R, Cusmà S, Midiri M, Brancatelli G. Abdominal splenosis and its differential diagnoses: What the radiologist needs to know. Curr Probl Diagn Radiol 2020; 50:229-235. [PMID: 32540140 DOI: 10.1067/j.cpradiol.2020.04.012] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Revised: 03/25/2020] [Accepted: 04/14/2020] [Indexed: 12/13/2022]
Abstract
Splenosis is a benign acquired condition characterized by the presence of heterotopic viable splenic tissue in other organs or within cavities such as peritoneum, retroperitoneum, or thorax after splenic trauma or surgery. Abdominal splenosis is often an incidental finding and computed tomography and magnetic resonance usually allow a confident diagnosis. The typical enhancement that parallels the spleen is a useful hallmark of splenosis. Splenic implants lack contrast uptake in the hepatobiliary phase and show high signal at high b-values on diffusion-weighted images. In some cases splenosis may mimic malignant and benign conditions in the peritoneum as well as in hollow and parenchymal abdominal organs and further investigations - including scintigraphy with Tc99m-labelled heat-denatured red blood cells or biopsy - are sometimes required in challenging cases. This pictorial essay reviews the imaging presentation and potential differential diagnosis of splenosis according to the site of implantation. A prompt and accurate radiological diagnosis of splenosis can avoid unnecessary biopsy or surgery.
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Affiliation(s)
- Federica Vernuccio
- Dipartimento Promozione della Salute, Materno-Infantile, di Medicina Interna e Specialistica di Eccellenza G. D'Alessandro, University of Palermo, Palermo, Italy; I.R.C.C.S, Centro Neurolesi Bonino Pulejo, Messina, Italy; Hôpitaux Universitaires Beaujon, Radiology, Université Paris VII, Clichy, France.
| | - Mariangela Dimarco
- Dipartimento di Biomedicina, Neuroscienze e Diagnostica avanzata (BIND), University of Palermo, Palermo, Italy
| | - Giorgia Porrello
- Dipartimento di Biomedicina, Neuroscienze e Diagnostica avanzata (BIND), University of Palermo, Palermo, Italy
| | - Roberto Cannella
- Dipartimento di Biomedicina, Neuroscienze e Diagnostica avanzata (BIND), University of Palermo, Palermo, Italy
| | - Silvestro Cusmà
- Radiology department, Oncologic Hospital "La Maddalena", Palermo, Italy
| | - Massimo Midiri
- Dipartimento di Biomedicina, Neuroscienze e Diagnostica avanzata (BIND), University of Palermo, Palermo, Italy
| | - Giuseppe Brancatelli
- Dipartimento di Biomedicina, Neuroscienze e Diagnostica avanzata (BIND), University of Palermo, Palermo, Italy
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Ananthan K, Yusuf GT, Kumar M. Intrahepatic and intra-abdominal splenosis: A case report and review of literature. World J Hepatol 2019; 11:773-779. [PMID: 31966909 PMCID: PMC6960294 DOI: 10.4254/wjh.v11.i12.773] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Revised: 11/11/2019] [Accepted: 11/26/2019] [Indexed: 02/06/2023] Open
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.
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Affiliation(s)
- Kiruthika Ananthan
- GKT School of Medical Education, King’s College London, London WC2R 2LS, United Kingdom
| | - Gibran Timothy Yusuf
- Department of Radiology, Princess Royal University Hospital, King’s College Hospital NHS Foundation Trust, Kent BR6 8ND, United Kingdom
| | - Mayur Kumar
- Department of Gastroenterology, Princess Royal University Hospital, King’s College Hospital NHS Foundation Trust, Kent BR6 8ND, United Kingdom
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Matsubayashi H, Bando E, Kagawa H, Sasaki K, Ishiwatari H, Ono H. A Multinodular Mass of Abdominal Splenosis: Case Report of Uncommon Images of a Rare Disease. Diagnostics (Basel) 2019; 9:diagnostics9030111. [PMID: 31487850 PMCID: PMC6787689 DOI: 10.3390/diagnostics9030111] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2019] [Revised: 09/01/2019] [Accepted: 09/02/2019] [Indexed: 01/11/2023] Open
Abstract
Splenosis is a rare disease which typically forms single or multiple round masses. A 45-year-old male was referred for investigation of an abdominal mass. He had a history of splenic injury from a traffic accident at age 19. Contrast-enhanced computed tomography showed a well-enhanced, multi-nodular mass lesion, 3.5 cm in size, located below the stomach. An endoscopic ultrasound-guided fine needle aspiration biopsy (EUS-FNAB) for the mass was inconclusive. A surgery was performed, and pathology of the resected mass confirmed splenosis. Clinicians must bear in mind the possibility of occurrence of splenosis after splenic trauma and its image variations.
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Affiliation(s)
| | - Etsuro Bando
- Division of Gastric Surgery, Shizuoka Cancer Center, Suntogun, Shizuoka 411-8777, Japan.
| | - Hiroyasu Kagawa
- Division of Colon and Rectal Surgery, Shizuoka Cancer Center, Suntogun, Shizuoka 411-8777, Japan.
| | - Keiko Sasaki
- Division of Pathology, Shizuoka Cancer Center, Suntogun, Shizuoka 411-8777, Japan.
| | - Hirotoshi Ishiwatari
- Division of Endoscopy, Shizuoka Cancer Center, Suntogun, Shizuoka 411-8777, Japan.
| | - Hiroyuki Ono
- Division of Endoscopy, Shizuoka Cancer Center, Suntogun, Shizuoka 411-8777, Japan.
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Human schistosomiasis in Benin: Countrywide evidence of Schistosoma haematobium predominance. Acta Trop 2019; 191:185-197. [PMID: 30633895 DOI: 10.1016/j.actatropica.2019.01.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2018] [Revised: 12/28/2018] [Accepted: 01/07/2019] [Indexed: 02/06/2023]
Abstract
BACKGROUND A national mapping of human schistosomiasis was conducted in Benin to provide the baseline epidemiological data required to implement the national strategy for schistosomiasis control and elimination to achieve the WHO's goal of reaching at least 75% of school-age children in endemic areas by 2020. METHODS Parasitological surveys were conducted from 2013 to 2015, among 19,250 children aged 8-14 years randomly sampled in 385 units (schools/villages) across all districts. Urine and stool samples were examined using parasite-egg filtration for urine samples and the Kato-Katz technique for stool specimens. RESULTS Human schistosome eggs from two major species (S. haematobium and S. mansoni) were detected in the surveyed population with variable prevalence and parasite intensity. Urinary schistosomiasis due to S. haematobium was widely distributed and detected in 76/77 districts with a national average prevalence of 17.56% (95 °CI:16.80%- 18.32%), compared to S. mansoni detected in 28/77 districts with a national prevalence of 2.45% (95 °CI:2.14%-2.76%). The combined national prevalence of schistosomiasis, defined by infections with either or both schistosome species was 19.78% (95% CI:18.90% -20.49%), and was detected in 76/77 districts. Based on our findings, 31 districts were classified as low-risk (>0% and <10%); 37 as moderate-risk (≥10% and <50%); and 8 as high-risk (≥50%) of schistosome infection. No infection was detected in Kpomassè district in this study. In several districts where the two species were endemic with prevalence ≥10%, S. haematobium was the most prevalent schistosome species. Boys were relatively more infected than girls (18.29% v 16.82%, p = 0.007). Of note, heavy infections with S. haematobium (>50 eggs/10 mL) were detected in several districts of Atacora, Donga, Borgou, Collines, Ouémé and Atlantique departments. CONCLUSIONS The schistosomiasis mapping reported here clearly present a nationwide view of the epidemiological pattern of Schistosoma infections and the baseline data for implementing an effective control strategy by preventive chemotherapy (PCT). Although PCT might not be required in 32/77 districts, a yearly and bi-annual deworming is needed in 2 and 43 districts, respectively. If no environmental change occurs, and no mass treatment is delivered, prevalence is likely to remain stable for many years owing to poor hygiene and sanitation.
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