Rare cause of pleural nodularity: Splenosis

Abstract

Splenosis is a rare condition described as ectopic splenic tissue implantation generally after a splenic rupture. A 35-year-old male patient who had a history of splenectomy operation due to gunshot wound seven years ago was referred to our hospital with complaints, including exhaustion, sweating and shortness of breath. Thoracic computed tomography of the patient showed nodular pleural thickenings at the level of the left lower lobe, which proved to be unrelated with the presenting symptoms. The patient underwent a minithoracotomy for diagnosis and treatment. During the intraoperative observation, dark-colored, soft, multiple nodular lesions with a biggest size of 2 cm inside the visceral pleura over an area of 5 x 10 cm in dimension were observed. Also, a few tiny nodules in the lung parenchyma approximately 1-cm deep to the pleural nodules were palpated. The lesions were excised. The histopathological examination of the specimen showed splenic tissue in the lung parenchyma and pleura, so the lesions were accepted as splenosis. Pleuropulmonary splenosis, which develops generally after simultaneous rupture of the diaphragma and spleen, is a very rare condition. Most of the patients are asymptomatic and the lesions are detected accidentally. If the diagnosis can be made preoperatively, surgical excision is not needed.