The (re)generation of splenic tissue

Area of Science:

• Medical Imaging
• Hepatology
• Surgical Pathology

Background:

• A 48-year-old male with a history of splenectomy presented with elevated liver enzymes.
• The patient had a confirmed diagnosis of alcoholic liver cirrhosis.

Observation:

• Abdominal ultrasound revealed hepatomegaly and a possible central liver mass.
• Abdominal MRI identified multiple ovoid structures in the intraperitoneal and retroperitoneal spaces.
• Peripheral blood smear lacked Howell-Jolly bodies, indicating preserved splenic function.

Findings:

• Splenosis was diagnosed, defined as splenic tissue autotransplantation post-rupture.
• SPECT-CT with technetium-99m labelled heat-denatured autologous red blood cells confirmed the diagnosis.
• The imaging findings ruled out a primary hepatic mass.

Implications:

• This case highlights splenosis as a potential mimic of hepatic masses in patients with a history of splenic trauma.
• Accurate diagnosis of splenosis is crucial for appropriate patient management and avoiding unnecessary interventions.
• SPECT-CT plays a vital role in confirming splenosis and differentiating it from other intra-abdominal pathologies.