(99m)Tc disphosphonate uptake due to splenosis: incidental finding 60 years after splenectomy

A 72-year-old man was referred for a triphasic bone scintigraphy to evaluate painful prosthetic implant of the knee. In all the study phases, images showed abnormal uptake close to the tibial portion of the implant. Interestingly, later whole-body images revealed high radiopharmaceutical accumulation in the left hypochondrium. Subsequent radiolabeled leukocyte scintigraphy confirmed radiotracer accumulation in the same localizations. As an important background the patient underwent splenectomy owing to Banti syndrome 60 years earlier. A Tc-labeled heat-damaged red blood cell scintigraphy was then performed, which confirmed radiopharmaceutical accumulation in the left hypochondrium being consistent with splenosis.