Ananthan K, Yusuf GT, Kumar M. Intrahepatic and intra-abdominal splenosis: A case report and review of literature. World J Hepatol 2019; 11(12): 773-779 [PMID: 31966909 DOI: 10.4254/wjh.v11.i12.773]
Corresponding Author of This Article
Mayur Kumar, FRCP (Hon), MBBS, MRCP, Doctor, Department of Gastroenterology, Princess Royal University Hospital, King’s College Hospital NHS Foundation Trust, Farnborough Common, Orpington, Kent BR6 8ND, United Kingdom. mayurkumar@nhs.net
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Kiruthika Ananthan, GKT School of Medical Education, King’s College London, London WC2R 2LS, United Kingdom
Gibran Timothy Yusuf, Department of Radiology, Princess Royal University Hospital, King’s College Hospital NHS Foundation Trust, Kent BR6 8ND, United Kingdom
Mayur Kumar, Department of Gastroenterology, Princess Royal University Hospital, King’s College Hospital NHS Foundation Trust, Kent BR6 8ND, United Kingdom
Author contributions: Ananthan K, Yusuf GT and Kumar M wrote and reviewed the paper; Yusuf GT additionally selected the images for the case report.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016) and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Mayur Kumar, FRCP (Hon), MBBS, MRCP, Doctor, Department of Gastroenterology, Princess Royal University Hospital, King’s College Hospital NHS Foundation Trust, Farnborough Common, Orpington, Kent BR6 8ND, United Kingdom. mayurkumar@nhs.net
Telephone: +44-203-2995844 Fax: +44-203-2996474
Received: August 22, 2019 Peer-review started: August 22, 2019 First decision: November 2, 2019 Revised: November 11, 2019 Accepted: November 25, 2019 Article in press: November 25, 2019 Published online: December 27, 2019 Processing time: 126 Days and 4.8 Hours
Abstract
BACKGROUND
Splenosis is defined as the process by which tissue from the spleen disseminates through the body and grows in an ectopic location following trauma or a splenectomy. Visceral sites of splenosis are rare.
CASE SUMMARY
We report a case of intrahepatic splenosis in a 57-year-old man with a history of trauma over 40 years ago who initially presented with chest pain. Findings initially mimicked malignancy but a diagnosis of intrahepatic splenosis was confirmed using computed tomography and scintigraphy with technetium-99m heat-denatured red blood cells (Tc-99 DRBC).
CONCLUSION
Scintigraphy with Tc-99 DRBC is a reliable technique to diagnose splenosis and should be performed before using more invasive procedures are carried out. Splenosis should be considered as a possible differential diagnosis for a hepatic nodule in any patient with a history of abdominal trauma, previous splenectomy or atypical radiological features on imaging.
Core tip: Intrahepatic splenosis is rare. On imaging it is difficult to distinguish splenosis from hepatic malignancy, particularly hepatocellular carcinoma. We report a case of a patient with intrahepatic and intra-abdominal splenosis diagnosed using scintigraphy with technetium-99m heat-denatured red blood cells. To the author’s knowledge, this is the first case where hepatic splenosis was confirmed without using invasive procedures such as biopsy or surgery. Splenosis should be considered as an important differential for a hepatic lesion in a patient with a history of trauma or splenectomy, particularly if the lesion is located near the capsule and associated with multiple abdominal deposits.
