Intrahepatic Splenosis: A Rare Case

Splenosis refers to the autotransplantation of splenic tissue in a heterotopic location throughout different anatomic compartments, such as the peritoneal and pelvic cavities and even the thoracic cavity. Intrahepatic splenosis is very rare and usually mistaken for a neoplasm. The lack of typical radiological features makes it difficult to distinguish splenosis from liver tumors.

A 33-year-old female patient presented with post-traumatic splenectomy and had a history of recurrent surgery afterward. There were no significant findings in the physical examination or lab values. Imaging findings were non-specific, with nodular lesions in the liver and scattered in the abdomen. Due to the patient's history, splenosis was considered in the differential diagnosis, and finally, scintigraphy was performed, which confirmed the diagnosis, so unnecessary surgery was avoided.

Splenosis is the implantation of splenic tissue after an elective or traumatic splenic rupture. US imaging indicates a hypoechoic to isoechoic mass. Low signal intensity on T1 and iso-to-high signal intensity on T2-weighted images are common MRI findings of splenosis. The arterial phase of spleen implantation is varied. Delayed phase signal intensity is usually less than the liver parenchyma. The spleen has the lowest ADC value and the most restricted diffusion of all the intra-abdominal organs.

In conclusion, splenosis should be considered in the differential diagnosis of patients with a history of spleen surgery or abdominal trauma. It should correlate with the clinical history.