Subcutaneous splenosis of the abdominal wall: report of a case and review of the literature

Abstract

Splenosis is a common benign condition that occurs after splenic rupture via trauma or surgery. The mechanism behind splenic cell autotransplantation begins with the splenic rupture, either from trauma or surgical removal. Splenosis is usually found incidentally and, unless symptomatic, surgical therapy is not indicated. Subcutaneous splenosis is an extremely rare form of splenosis, mostly observed in abdominal surgical scars. We report a case of subcutaneous splenosis, as well as a comprehensive review of the literature. In our case, a 43-year-old woman who had splenectomy after traumatic splenic rupture at the age of 7 years old presented for plastic reconstruction of her postoperative scar. Upon surgery, two asymptomatic subcutaneous nodules were incidentally discovered. The presence of splenic tissue was confirmed by the histological study. The nodules were not excised, as the patient was not symptomatic.

Figure 1

Splenic tissue (H&E). The splenic capsule is thick and trabeculae connective tissue vaguely subdivides the organ.

Figure 2

Thick connective tissue containing blood vessels next to red pulp of the spleen.

Figure 3

The red pulp consists of a complex network of venous sinuses and the cords of Billroth. The cords contain most of the splenic macrophages. The sinuses have a discontinuous wall which allows traffic of blood cells between cords and sinuses.

Figure 4

Nodules of splenic tissue clearly separated by the connective tissue of the capsule.