Hepatic splenosis presenting as arterialised liver lesion in a patient with NASH

Splenosis represents the heterotopic autotransplantation of splenic tissue after a traumatic splenic rupture and splenectomy. It is not a rare condition and it is estimated to occur in up to 67% of patients with traumatic splenic rupture.

We report one case of patient, affected by non alcoholic steatohepatitis (NASH), with a hypervascularised liver lesion, that the final histological examination revealed hepatic splenosis. This is a rare condition that may be misinterpreted as adenoma or hepatocellular carcinoma (HCC). Imaging techniques and features that might contribute to the diagnosis and may avoid invasive treatment are also discussed. Although hepatic splenosis is a rare condition, this diagnosis should be considered in patients with previous history of abdominal trauma and then the diagnosis of splenosis may be confirmed by Tc-99m-DRBC scintigraphy, avoiding biopsy or further surgery.