Thoracic splenosis: History is the key

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.

Fig. 1

Selected slices of Chest CT Scan showing multiple pulmonary nodules in the left lung. From left to right: Coronal View, Sagittal View and Transaxial View.

Fig. 2

Selected views of the Tc-99m sulfur colloid nuclear scan showing increased radiotracer uptake within the pulmonary nodules in the left lower and upper lobes. From left to right: Coronal View, Sagittal View and Transaxial View.

Fig. 3

Selected views of the Fused image showing increased radiotracer uptake within the pulmonary nodules in the left lower and upper lobes. From left to right: Coronal View, Sagittal View and Transaxial View.