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Case Reports
. 2019 Mar 20;12(3):e228510.
doi: 10.1136/bcr-2018-228510.

Intrapancreatic accessory spleen: an enigmatic entity

Namita Chavan  1 , Gunjan Shailesh Desai  1 , Chandralekha Tampi  2 , Prasad Wagle  1
Affiliations
Case Reports

Intrapancreatic accessory spleen: an enigmatic entity

Namita Chavan et al. BMJ Case Rep. .

Abstract

Solitary hypervascular lesion in the distal body/tail of pancreas in a patient with non-specific abdominal symptoms is a diagnostic challenge. Neuroendocrine neoplasm (NEN) and metastasis from renal cell carcinoma are the most common differentials and intrapancreatic accessory spleen (IPAS) is the rarest of its differential diagnosis. We present, here, a case of a 56-year-old man with a space-occupying lesion in body/tail of pancreas that was preoperatively diagnosed as a NEN based on elevated chromogranin levels and hyperenhancing lesion on contrast-enhanced CT scan. He underwent a spleen-preserving distal pancreatectomy. The final histopathology revealed an IPAS.

Keywords: neuroendocrinology; pancreas and biliary tract; pancreatic cancer; radiology (diagnostics); surgical oncology.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
(A) Non-contrast CT abdomen, axial image, showing the lesion in distal body of pancreas, no calcification; (B) Contrast-enhanced CT (CECT) abdomen, arterial phase, axial image shows the hyperenhancing lesion in distal body of pancreas; (C) CECT abdomen, portal phase, axial image shows the washing out of the lesion in distal body of pancreas and (D) CECT abdomen, venous phase, axial image shows washout of the contrast from the lesion in distal body of pancreas.
Figure 2
Figure 2
H&E stain (×40 magnification) shows the red and white pulp, and the adjacent pancreatic tissue.
Figure 3
Figure 3
Immunohistochemistry with cluster of differentiation 8 highlights the littoral cells, confirming a spleniculi.
See this image and copyright information in PMC

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