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Ridge PC, Chen-Maxwell D, Brodie C, Quinn AM, Bruzzi J, Breen D. A pleural based mass in a post-partum woman. Breathe (Sheff) 2023; 19:230156. [PMID: 38351948 PMCID: PMC10862123 DOI: 10.1183/20734735.0156-2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Accepted: 12/14/2023] [Indexed: 02/16/2024] Open
Abstract
Can you diagnose this case of a 27-year-old female who presented 1-week post-partum with an incidental finding of intrathoracic masses and probable hilar lymphadenopathy? https://bit.ly/3S3ejVK.
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Affiliation(s)
- Padraic C. Ridge
- Interventional Respiratory Unit, Department of Respiratory Medicine, Galway University Hospitals, Galway, Ireland
| | | | - Caroline Brodie
- Pathology Department, Galway University Hospitals, Galway, Ireland
| | - Anne Marie Quinn
- Pathology Department, Galway University Hospitals, Galway, Ireland
| | - John Bruzzi
- Radiology Department, Galway University Hospitals, Galway, Ireland
| | - David Breen
- Interventional Respiratory Unit, Department of Respiratory Medicine, Galway University Hospitals, Galway, Ireland
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2
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Maddamma S, Owusu-Ansah KG, Barreiro T. Posttraumatic thoracic splenosis in a 77-year-old patient after a motor vehicle accident. Respir Med Case Rep 2023; 44:101860. [PMID: 37288446 PMCID: PMC10241966 DOI: 10.1016/j.rmcr.2023.101860] [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: 01/08/2023] [Revised: 04/20/2023] [Accepted: 04/25/2023] [Indexed: 06/09/2023] Open
Abstract
We present a rare case of autotransplantation of splenic tissue to the thoracic cavity, concerning for lung tumor, after splenic and diaphragmatic injury following a severe motor vehicle accident 27 years previous.
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Affiliation(s)
- Suzanne Maddamma
- Department of Internal Medicine, St. Elizabeth Youngstown Hospital, Youngstown, OH, USA
- Department of Medicine, Northeastern Ohio Medical University, Rootstown, OH, USA
| | - Kwabena G. Owusu-Ansah
- Department of Internal Medicine, St. Elizabeth Youngstown Hospital, Youngstown, OH, USA
- Department of Medicine, Northeastern Ohio Medical University, Rootstown, OH, USA
| | - Timothy Barreiro
- Department of Internal Medicine, St. Elizabeth Youngstown Hospital, Youngstown, OH, USA
- Department of Medicine, Northeastern Ohio Medical University, Rootstown, OH, USA
- Ohio University Heritage College of Osteopathic Medicine, Athens, OH, USA
- Lake Erie College of Osteopathic Medicine, Erie, PA, USA
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3
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Calcification in Thoracic Splenosis. Case Rep Pulmonol 2022; 2022:9538355. [PMID: 36267804 PMCID: PMC9578903 DOI: 10.1155/2022/9538355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Accepted: 09/27/2022] [Indexed: 11/17/2022] Open
Abstract
Splenosis is a rare condition described as the implantation of ectopic splenic tissue, usually after a splenic rupture. Thoracic splenosis refers to acquired ectopic splenic tissue found within the thoracic cavity, often caused by thoracoabdominal trauma or surgery. Most cases are asymptomatic and many years may elapse before they are incidentally discovered on chest radiography or thoracic computed tomography. Splenosis is often misinterpreted as a malignancy on initial imaging. We wish to highlight a rare case of thoracic splenosis presenting with calcified and non-calcified nodules. Only two other cases of calcification have been reported in intrathoracic splenosis, neither of which provided CT images of this finding.
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4
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Sönmez Ö, Kılıç B, Turna A. Thoracic splenosis mimicking pleural tumor after firearm injury: A case report with long-term follow-up. ULUS TRAVMA ACIL CER 2022; 28:222-224. [PMID: 35099033 PMCID: PMC10443152 DOI: 10.14744/tjtes.2020.45787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Accepted: 05/30/2020] [Indexed: 11/20/2022]
Abstract
Splenosis describe a clinical entity of autotransplantation after removal of the spleen secon-dary to a traumatic rupture or surgery. A 39-year-old female was referred to thoracic surgery department with complaints of severe chest pain. She had left thoracic and abdominal gun-shot injury that occurred 19 years earlier. Thorax computed tomograhy and thorax magnetic resonance imaging revealed pleural lesions. A video thoracoscopic biopsy disclosed splenosis in the patient. Splenic implants did not change in 6 years. The patient has mild thoracic pain. Thoracic splenosis can occur in patients who underwent abdominothoracic gunshot injury. The implants did not seem to change in long-term follow-up. Thoracic splenosis may occur, persist for years and it mimics pleural tumor after abdominal gun-shot injury and does not seem to necessitate any surgical intervention including diaphragmatic repair.
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Affiliation(s)
- Özge Sönmez
- Department of Thoracic Surgery, İstanbul University-Cerrahpaşa Cerrahpaşa Faculty of Medicine, İstanbul-Turkey
| | - Burcu Kılıç
- Department of Thoracic Surgery, İstanbul University-Cerrahpaşa Cerrahpaşa Faculty of Medicine, İstanbul-Turkey
| | - Akif Turna
- Department of Thoracic Surgery, İstanbul University-Cerrahpaşa Cerrahpaşa Faculty of Medicine, İstanbul-Turkey
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5
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Al Dandan O, Hassan A, Alsaif HS, Altalaq S, Al-Othman A, Aljawad B, Alhajjaj G, Alshomimi S. Splenosis of the Mesoappendix with Acute Appendicitis: A Case Report. AMERICAN JOURNAL OF CASE REPORTS 2020; 21:e921685. [PMID: 32301443 PMCID: PMC7194463 DOI: 10.12659/ajcr.921685] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
BACKGROUND Splenosis is a benign condition involving the auto-transplantation of splenic tissue at various locations, resulting from splenic injury or splenectomy. CASE REPORT A 40-year-old male, with a history of remote exploratory laparotomy with splenectomy secondary to blunt abdominal trauma, presented with symptoms consistent with acute appendicitis, which was subsequently confirmed by computed tomography scan of the abdomen that further demonstrated the presence of multiple abdominal nodules, one of which was adjacent to the appendix. A laparoscopic appendectomy was then performed along with resection of the nodule located in the mesoappendix, which was confirmed to be a splenic tissue based on histopathological examination. CONCLUSIONS Abdominal splenosis is not an uncommon condition in patients with a history of splenic injury. However, the involvement of the mesoappendix, which may or may not contribute to acute inflammation of the appendix, is very rare.
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Affiliation(s)
- Omran Al Dandan
- Department of Radiology, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Al-Khobar, Saudi Arabia
| | - Ali Hassan
- Department of Emergency Medicine, Bahrain Specialist Hospital, Al-Juffair, Bahrain
| | - Hind S Alsaif
- Department of Radiology, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Al-Khobar, Saudi Arabia
| | - Sukaina Altalaq
- Department of Pathology, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Al-Khobar, Saudi Arabia
| | - Anas Al-Othman
- Department of General Surgery, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Al-Khobar, Saudi Arabia
| | - Bayan Aljawad
- Department of General Surgery, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Al-Khobar, Saudi Arabia
| | - Ghadeer Alhajjaj
- Department of General Surgery, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Al-Khobar, Saudi Arabia
| | - Saeed Alshomimi
- Department of General Surgery, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Al-Khobar, Saudi Arabia
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6
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Ha YJ, Hong TH, Choi YS. Thoracic Splenosis after Splenic and Diaphragmatic Injury. THE KOREAN JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY 2019; 52:47-50. [PMID: 30834219 PMCID: PMC6383850 DOI: 10.5090/kjtcs.2019.52.1.47] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Revised: 09/16/2018] [Accepted: 09/17/2018] [Indexed: 12/26/2022]
Abstract
Thoracic splenosis is a rare disease that develops as a result of autotransplantation of splenic tissue into the thoracic cavity following splenic and diaphragmatic injury. We report the case of a 53-year-old man with a chief complaint of heartburn and cough. He had a history of traumatic diaphragmatic rupture treated with surgical repair and splenectomy 15 years ago. Imaging studies revealed a paraesophageal mass, and surgical resection was performed considering the possibility of Castleman disease or an esophageal submucosal tumor. Pathologic results showed findings of normal splenic tissue. The patient was discharged on postoperative day 5 without any complications.
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Affiliation(s)
- You Jin Ha
- Department of Thoracic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine
| | - Tae Hee Hong
- Department of Thoracic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine
| | - Yong Soo Choi
- Department of Thoracic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine
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7
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Williams K, Simpson G. Thoracic splenosis: diagnosis without invasive investigations. Respirol Case Rep 2017; 5:e00274. [PMID: 28944061 PMCID: PMC5608887 DOI: 10.1002/rcr2.274] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2017] [Revised: 08/07/2017] [Accepted: 08/13/2017] [Indexed: 11/09/2022] Open
Abstract
This case report describes a case of thoracic splenosis. Splenosis is often interpreted as malignancy on initial imaging. Case reports described in the literature reveal that diagnosis is most often confirmed with invasive investigations. A 99 m technetium‐labelled sulphur colloid scan when used with single photon emission computed tomography/computed tomography (SPECT/CT) is highly specific for splenic tissue and more readily available and time efficient than other modalities used for this purpose. Awareness of this may prevent unnecessary or dangerous invasive diagnostic procedures.
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Affiliation(s)
- Kirryn Williams
- Department of Thoracic Medicine Cairns Hospital, Queensland Health Cairns Queensland Australia
| | - Graham Simpson
- Department of Thoracic Medicine Cairns Hospital, Queensland Health Cairns Queensland Australia
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8
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Ferrer Marrero TM, Prieto-Centurion V, Jaffe HA. Thoracic splenosis: History is the key. Respir Med Case Rep 2017; 22:251-253. [PMID: 28971001 PMCID: PMC5612806 DOI: 10.1016/j.rmcr.2017.09.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2017] [Revised: 09/11/2017] [Accepted: 09/12/2017] [Indexed: 10/25/2022] Open
Abstract
Splenosis is an acquired ectopic autotransplantation of splenic tissue; that occurs after traumatic splenic rupture and splenectomy [1]. Splenosis is a rare but benign disease, and the diagnosis can be challenging as the multiple incidentally found nodules could mimic malignancy [2]. Abdominopelvic Splenosis is thought to occur in as many as 65% of cases of splenic rupture [1]. However, Thoracic Splenosis is rare and usually involve the left parietal and visceral pleura [1,2]. Intraparenchymal lesions are less common but have been reported in cases of parenchymal and diaphragm laceration [1,2]. Taking a thorough history is of utmost importance, as these patients usually present more than two decades after the splenic traumatic rupture. The use of commonly available nuclear studies will further confirm the diagnosis [3]. This will help to avoid unnecessary procedures, like biopsies; and prevent the potential complications. We present a case of Thoracic Splenosis that highlights the importance of taking a detailed history; and the importance of using nuclear studies for the diagnosis. Further adding to its uniqueness, this case showed with multiple intraparenchymal nodules which is a less common presentation of Splenosis.
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Affiliation(s)
| | - Valentin Prieto-Centurion
- University of Illinois at Chicago, Chicago, IL, United States
- Jesse Brown VA Medical Center, Chicago, IL, United States
| | - Howard A. Jaffe
- University of Illinois at Chicago, Chicago, IL, United States
- Jesse Brown VA Medical Center, Chicago, IL, United States
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Baldolli A, Coeuret S, Le Pennec V, Agostini D, Verdon R. Thoracic splenosis mimicking a pleuropneumonia: A case report. Medicine (Baltimore) 2017; 96:e7552. [PMID: 28723778 PMCID: PMC5521918 DOI: 10.1097/md.0000000000007552] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2017] [Revised: 05/31/2017] [Accepted: 06/27/2017] [Indexed: 12/25/2022] Open
Abstract
RATIONALE Splenosis is the development of one or more heterotopic splenic tissue autoimplants following rupture of the spleen and remains mostly asymptomatic. PATIENT CONCERNS We report a case of a 50-year old post-traumatic splenectomized man admitted for a left side community acquired pneumonia resistant to antibiotics. DIAGNOSES The diagnosis of intrathoracic ectopic spleen was suspected because of the history of spleen trauma with diaphragm rupture and the absence of Howell-Jolly bodies. INTERVENTIONS Technetium (Tc)-m colloid scintigraphy SPECT, fused with CT scan showed an intense radionuclide uptake on hyper vascularized masses without any additional pathologic uptake and confirmed the diagnosis of thoracic splenosis. OUTCOMES Despite any lifelong penicillin prophylaxis, he had no history of infections eight years after the diagnosis. LESSONS Physician must be aware of this differential diagnosis and of its consequences. Depending on its size and location, it may lead to incorrect diagnosis (tumor, empyema, abscess ...), treatment and invasive procedures while the diagnosis of splenosis only relies upon imaging studies associated with functionnal study of the uptake of particles or cells.
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Affiliation(s)
- Aurélie Baldolli
- CHU de Caen, France, Infectious Diseases Department
- Groupe de Recherche sur l’Adaptation Microbienne (GRAM 2.0), Normandie University, UNICAEN Caen, PFRS, 2 rue des Rochambelles, Caen, France
| | | | | | | | - Renaud Verdon
- CHU de Caen, France, Infectious Diseases Department
- Groupe de Recherche sur l’Adaptation Microbienne (GRAM 2.0), Normandie University, UNICAEN Caen, PFRS, 2 rue des Rochambelles, Caen, France
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10
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Gelsomino F, Castellani MR, Marchianò A, Duca M, Mariani P, Aliberti G, Maccauro M, Duranti L, Capri G, de Braud FG, Bianchi GV. Pitfalls in oncology: a unique case of thoracic splenosis mimicking malignancy in a patient with resected breast cancer. J Thorac Dis 2016; 8:E403-7. [PMID: 27293867 DOI: 10.21037/jtd.2016.04.54] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Thoracic splenosis (TS) is a condition of autotransplantation of splenic tissue into the pleural cavity after thoraco-abdominal trauma, with diaphragmatic and spleen injury. It is usually asymptomatic and discovered as an incidental finding at imaging performed for other reasons. Its differential diagnosis regards different benign and malignant conditions and should be discerned avoiding invasive procedures. We report a case of thoracic mass associated with pleural nodules mimicking malignancy in a patient with resected breast cancer for whom a diagnosis of TS was made early by using non-invasive methods. Briefly, we review the literature data on TS, comment concisely the possible implications of using invasive procedures and describe the current non-invasive techniques available. Furthermore, we highlight the importance of an accurate medical history collection, the role of the multidisciplinary board and their impact on treatment decision making. Finally, we conclude that clinical information and imaging would be the discriminating factors to avoid unnecessary invasive procedures.
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Affiliation(s)
- Francesco Gelsomino
- 1 Medical Oncology Unit 1, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Italy ; 2 Nuclear Medicina Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Italy ; 3 Radiology Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Italy ; 4 Thoracic Surgery Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Italy
| | - Maria Rita Castellani
- 1 Medical Oncology Unit 1, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Italy ; 2 Nuclear Medicina Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Italy ; 3 Radiology Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Italy ; 4 Thoracic Surgery Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Italy
| | - Alfonso Marchianò
- 1 Medical Oncology Unit 1, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Italy ; 2 Nuclear Medicina Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Italy ; 3 Radiology Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Italy ; 4 Thoracic Surgery Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Italy
| | - Matteo Duca
- 1 Medical Oncology Unit 1, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Italy ; 2 Nuclear Medicina Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Italy ; 3 Radiology Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Italy ; 4 Thoracic Surgery Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Italy
| | - Paola Mariani
- 1 Medical Oncology Unit 1, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Italy ; 2 Nuclear Medicina Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Italy ; 3 Radiology Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Italy ; 4 Thoracic Surgery Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Italy
| | - Gianluca Aliberti
- 1 Medical Oncology Unit 1, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Italy ; 2 Nuclear Medicina Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Italy ; 3 Radiology Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Italy ; 4 Thoracic Surgery Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Italy
| | - Marco Maccauro
- 1 Medical Oncology Unit 1, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Italy ; 2 Nuclear Medicina Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Italy ; 3 Radiology Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Italy ; 4 Thoracic Surgery Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Italy
| | - Leonardo Duranti
- 1 Medical Oncology Unit 1, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Italy ; 2 Nuclear Medicina Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Italy ; 3 Radiology Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Italy ; 4 Thoracic Surgery Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Italy
| | - Giuseppe Capri
- 1 Medical Oncology Unit 1, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Italy ; 2 Nuclear Medicina Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Italy ; 3 Radiology Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Italy ; 4 Thoracic Surgery Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Italy
| | - Filippo Guglielmo de Braud
- 1 Medical Oncology Unit 1, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Italy ; 2 Nuclear Medicina Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Italy ; 3 Radiology Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Italy ; 4 Thoracic Surgery Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Italy
| | - Giulia Valeria Bianchi
- 1 Medical Oncology Unit 1, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Italy ; 2 Nuclear Medicina Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Italy ; 3 Radiology Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Italy ; 4 Thoracic Surgery Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Italy
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11
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Two Rare Cases of Intrathoracic Splenosis and Subcutaneous Splenosis: Spleen Scintigraphy Avoided the Need for Invasive Procedures. Nucl Med Mol Imaging 2015; 50:76-9. [PMID: 26941863 DOI: 10.1007/s13139-015-0370-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2015] [Revised: 08/30/2015] [Accepted: 09/07/2015] [Indexed: 01/28/2023] Open
Abstract
Splenosis is defined as the acquired heterotopic autotransplantation of splenic tissue in other sites of the body after splenic rupture, usually due to either traumatic or iatrogenic causes. It is often found incidentally and is usually asymptomatic. These implants are not limited to the left upper quadrant of the abdomen, however, and splenosis in other locations can mimic various pathologic entities. There are several reports on abdominal splenosis, but intrathoracic and subcutaneous splenosis are rare. We report two cases of intrathoracic and subcutaneous splenosis that were diagnosed using spleen scintigraphy, avoiding the need for an invasive procedure.
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12
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Lopes B, Almeida LR, Vicente AA, Marcellos DC, Corassa M, Romano RF, Freire F. Thoracic splenosis as a differential diagnosis of juxtapleural nodules. Respir Med Case Rep 2013; 11:1-3. [PMID: 26029518 PMCID: PMC3969606 DOI: 10.1016/j.rmcr.2013.10.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2013] [Revised: 08/24/2013] [Accepted: 10/04/2013] [Indexed: 01/04/2023] Open
Abstract
Thoracic splenosis is rare and consists of ectopic implantation of splenic tissue into the chest after concomitant thoracic and abdominal trauma with diaphragm injury. It occurs in about 18% of cases of splenic ruptures. In almost all cases, diagnosis is given incidentally once patients are usually asymptomatic. Thoracic splenosis should be considered as a differential diagnosis in all patients with history of trauma presenting with juxtapleural nodules in chest computed tomography. However, malignant conditions should be ruled out firstly. Biopsy is not essential for the diagnosis once nuclear medicine can confirm splenosis in patients with pertinent history of trauma and suggestive tomographic image. We present a typical case of thoracic splenosis whose diagnosis was made by nuclear medicine and no invasive procedures were required.
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Affiliation(s)
- B Lopes
- Department of Internal Medicine, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
| | - L R Almeida
- Department of Internal Medicine, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
| | - A A Vicente
- Department of Internal Medicine, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
| | - D C Marcellos
- Department of Internal Medicine, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
| | - M Corassa
- Department of Internal Medicine, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
| | - R F Romano
- Department of Radiology, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
| | - F Freire
- Department of Internal Medicine, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
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13
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Kellert B, Caster M, Des Jean R, Vaccarello L. Diffuse intra-abdominal splenosis presenting as carcinomatosis exhibiting positron emitted tomography hypermetabolic activity. GYNECOLOGIC ONCOLOGY CASE REPORTS 2013; 5:46-8. [PMID: 24371695 PMCID: PMC3862292 DOI: 10.1016/j.gynor.2013.03.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/12/2013] [Accepted: 03/22/2013] [Indexed: 12/28/2022]
Abstract
Splenosis can mimic carcinomatosis upon many imaging modalities. History of splenectomy must be considered when evaluating carcinomatosis. Scintigraphy is the preferred for confirming the presence of splenosis.
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Affiliation(s)
- Brian Kellert
- The Ohio State University/Mount Carmel Health OB/GYN Residency Program, 395 W State St, 5th Floor, Columbus, OH 43210, United States
- Corresponding author at: The Ohio State University/Mount Carmel Health OB/GYN Residency Program, 395 W State St, 5th Floor, Columbus, OH 43210, United States. Fax: + 1 614 293 5877.
| | - Michelle Caster
- The Ohio State University/Mount Carmel Health OB/GYN Residency Program, 395 W State St, 5th Floor, Columbus, OH 43210, United States
| | - Ryan Des Jean
- Mount Carmel Health System, Mount Carmel East Hospital, Department of Pathology, 5959 E Broad Street, Columbus, OH 43213, United States
| | - Luis Vaccarello
- The Zangmeister Cancer Center, 3100 Plaza Properties Blvd, Columbus, OH 43219, United States
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14
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Liu Y, Ji B, Wang G, Wang Y. Abdominal multiple splenosis mimicking liver and colon tumors: a case report and review of the literature. Int J Med Sci 2012; 9:174-7. [PMID: 22359484 PMCID: PMC3283864 DOI: 10.7150/ijms.3983] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2011] [Accepted: 01/18/2012] [Indexed: 12/11/2022] Open
Abstract
Splenosis is not an uncommon disease. However, it is often misdiagnosed as malignant tumors, and then the patients underwent unnecessary operations. Unfortunately, it is very difficult to diagnose it prior to operation. We report a rare case of a 49-year-old female patient with liver and colon splenosis, misdiagnosed as liver and colon tumors, and summarize experience how to diagnose it preoperatively according to literatures. We come to conclusion that in patients who ever underwent splenectomy especially owning to trauma, and were found mass in abdomen, clinicians must consider the existence of splenosis, and take some measures, such as scintigraphy with (99m) Tc labelled heat-denatured erythrocyte rather than biopsy, to diagnose it correctly to prevent unnecessary operations.
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Affiliation(s)
- Yahui Liu
- Department of Hepatobiliary and Pancreatic Surgery, the First Bethune Hospital, Jilin University, Jilin 130021, China
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