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...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.展开更多
BACKGROUND Splenosis is a rare benign disease that often disguises itself as a malignant tumor.There are few articles providing a comprehensive description of splenosis,especially cases located in the stomach being tr...BACKGROUND Splenosis is a rare benign disease that often disguises itself as a malignant tumor.There are few articles providing a comprehensive description of splenosis,especially cases located in the stomach being treated by laparoscopic surgery.CASE SUMMARY A 44-year-old man presented with recurrent upper abdominal pain for more than half a year.The patient had splenic rupture caused by trauma more than 10 years ago and underwent splenectomy.An abdominal contrast-enhanced computed tomography scan revealed an irregular soft tissue density.Gastroscopy revealed an approximately 3.0 cm×3.0 cm mucosal eminence at the posterior wall of the upper segment of the gastric body.Biopsy was not performed since the lesion was found under the mucosa and the gastric mucosa appeared normal.According to these findings,a diagnosis of gastric stromal tumor was made,although a definitive differential diagnosis was not known before surgery.When laparoscopic resection of the gastric stromal tumor was performed,an astonishing finding was made when postoperative pathology showed that the lesion comprised typical spleen tissue.CONCLUSION This case highlights the strong similarities between splenosis and malignant tumors.A detailed medical history combined with various effective auxiliary examinations can help improve differential diagnosis.展开更多
BACKGROUND‘Splenosis’is defined as the autotransplantation of splenic tissue following trauma or surgery,usually in the form of intraperitoneal nodules.The proliferation of imaging techniques has resulted in increas...BACKGROUND‘Splenosis’is defined as the autotransplantation of splenic tissue following trauma or surgery,usually in the form of intraperitoneal nodules.The proliferation of imaging techniques has resulted in increased unexpected discoveries of splenosis nodules,and achieving a differential diagnosis can be challenging.Nuclear medicine studies have been playing an increasingly important role in this process,but the clinical significance of asymptomatic nodules remains uncertain.CASE SUMMARY We present a case of pelvic splenosis in a 73-year-old man diagnosed 56 years after a splenectomy during a computed tomography(CT)follow-up for B-cell lymphoma,presenting intense contrast enhancement of an 18 mm nodule in the right recto-vesical space.18F-fluorodeoxyglucose demonstrated weak metabolic activity.Since histological diagnosis was deemed necessary,the nodule was easily removed with robotically assisted laparoscopy,together with another 6 mm left a paracolic lesion.The latter was previously undiagnosed but retrospectively visible on the CT scan.CONCLUSION In a patient requiring differential diagnosis of splenosis nodules from lymphomarecurrence, the robotic approach provided a safe en bloc removal with shorthospitalization. The Da Vinci Xi robot was particularly helpful because its opticscan be introduced from all ports, facilitating visualization and lysis of multipleintra-abdominal adhesions.展开更多
BACKGROUND Mass lesions located in the wall of the stomach(and also of the bowel)are referred to as“intramural.”The differential diagnosis of such lesions can be challenging in some cases.As such,it may occur that a...BACKGROUND Mass lesions located in the wall of the stomach(and also of the bowel)are referred to as“intramural.”The differential diagnosis of such lesions can be challenging in some cases.As such,it may occur that an inconclusive fine needle aspiration(FNA)result give way to an unexpected diagnosis upon final surgical pathology.Herein,we present a case of an intramural gastric nodule mimicking a gastric gastrointestinal stromal tumor(GIST).CASE SUMMARY A 47-year-old Caucasian woman,who had undergone splenectomy for trauma at the age of 16,underwent gastroscopy for long-lasting epigastric pain and dyspepsia.It revealed a 15 mm submucosal nodule bulging into the gastric lumen with smooth margins and normal overlying mucosa.A thoraco-abdominal computed tomography scan showed in the gastric fundus a rounded mass(30 mm in diameter)with an exophytic growth and intense enhancement after administration of intravenous contrast.Endoscopic ultrasound scan showed a hypoechoic nodule,and fine needle FNA was inconclusive.Gastric GIST was considered the most probable diagnosis,and surgical resection was proposed due to symptoms.A laparoscopic gastric wedge resection was performed.The postoperative course was uneventful,and the patient was discharged on the seventh postoperative day.The final pathology report described a rounded encapsulated accumulation of lymphoid tissue of about 4 cm in diameter consistent with spleen parenchyma implanted during the previous splenectomy.CONCLUSION Splenosis is a rare condition that should always be considered as a possible diagnosis in splenectomized patients who present with an intramural gastric nodule.展开更多
Thoracic splenosis is the autotransplantation of splenic tissue in the left thoracic cavity as a result of a splenic injury. This rare pathology is usually asymptomatic and may be discovered on incidental imaging, but...Thoracic splenosis is the autotransplantation of splenic tissue in the left thoracic cavity as a result of a splenic injury. This rare pathology is usually asymptomatic and may be discovered on incidental imaging, but the diagnosis often requires invasive procedures such as surgery in order to eliminate a neoplasic origin. We report a rare symptomatic case of a 39-year-old man presenting with chest pain and multiple nodules revealed on a computed tomography scan. The patient underwent a surgical exploration and the pathological studies concluded to a thoracic splenosis. Indeed, the previous medical history of the patient revealed a left thoraco-abdominal traumatism during childhood. The aim of this paper is to emphasize that the diagnosis can now be performed using only imaging techniques such as technetium-99 sulfur colloid or labelled heat-denatured red blood cell scintigraphy to avoid unnecessary invasive procedures including thoracotomy.展开更多
A 61-year-old man with locally advanced prostate cancer was found to have multiple solid intra-abdominal solid lesions during staging investigations.While some were in the pelvis,they were not located in the common la...A 61-year-old man with locally advanced prostate cancer was found to have multiple solid intra-abdominal solid lesions during staging investigations.While some were in the pelvis,they were not located in the common landing sites for prostate cancer metastases,and his prostate specific antigen was not significantly elevated to suggest a high burden of metastatic disease.He reported a history of a blunt abdominal trauma due to a motor vehicle accident more than forty years ago which had been conservatively managed.His staging imaging revealed a lack of a discrete spleen in his left upper abdomen and this raised the suspicion that these solid lesions may represent ectopic splenic tissue.Imaging with nuclear medicine scintigraphy confirmed the lesions in his upper abdomen and pelvis to be splenunculi.He proceeded with a combination of androgen deprivation therapy and external beam radiotherapy for locally advanced,non-metastatic prostate cancer.Although it has been described in patients with low risk prostate cancer,this is the first case report of splenunculi mimicking metastases in a patient with locally advanced prostate cancer.展开更多
文摘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.
文摘BACKGROUND Splenosis is a rare benign disease that often disguises itself as a malignant tumor.There are few articles providing a comprehensive description of splenosis,especially cases located in the stomach being treated by laparoscopic surgery.CASE SUMMARY A 44-year-old man presented with recurrent upper abdominal pain for more than half a year.The patient had splenic rupture caused by trauma more than 10 years ago and underwent splenectomy.An abdominal contrast-enhanced computed tomography scan revealed an irregular soft tissue density.Gastroscopy revealed an approximately 3.0 cm×3.0 cm mucosal eminence at the posterior wall of the upper segment of the gastric body.Biopsy was not performed since the lesion was found under the mucosa and the gastric mucosa appeared normal.According to these findings,a diagnosis of gastric stromal tumor was made,although a definitive differential diagnosis was not known before surgery.When laparoscopic resection of the gastric stromal tumor was performed,an astonishing finding was made when postoperative pathology showed that the lesion comprised typical spleen tissue.CONCLUSION This case highlights the strong similarities between splenosis and malignant tumors.A detailed medical history combined with various effective auxiliary examinations can help improve differential diagnosis.
文摘BACKGROUND‘Splenosis’is defined as the autotransplantation of splenic tissue following trauma or surgery,usually in the form of intraperitoneal nodules.The proliferation of imaging techniques has resulted in increased unexpected discoveries of splenosis nodules,and achieving a differential diagnosis can be challenging.Nuclear medicine studies have been playing an increasingly important role in this process,but the clinical significance of asymptomatic nodules remains uncertain.CASE SUMMARY We present a case of pelvic splenosis in a 73-year-old man diagnosed 56 years after a splenectomy during a computed tomography(CT)follow-up for B-cell lymphoma,presenting intense contrast enhancement of an 18 mm nodule in the right recto-vesical space.18F-fluorodeoxyglucose demonstrated weak metabolic activity.Since histological diagnosis was deemed necessary,the nodule was easily removed with robotically assisted laparoscopy,together with another 6 mm left a paracolic lesion.The latter was previously undiagnosed but retrospectively visible on the CT scan.CONCLUSION In a patient requiring differential diagnosis of splenosis nodules from lymphomarecurrence, the robotic approach provided a safe en bloc removal with shorthospitalization. The Da Vinci Xi robot was particularly helpful because its opticscan be introduced from all ports, facilitating visualization and lysis of multipleintra-abdominal adhesions.
文摘BACKGROUND Mass lesions located in the wall of the stomach(and also of the bowel)are referred to as“intramural.”The differential diagnosis of such lesions can be challenging in some cases.As such,it may occur that an inconclusive fine needle aspiration(FNA)result give way to an unexpected diagnosis upon final surgical pathology.Herein,we present a case of an intramural gastric nodule mimicking a gastric gastrointestinal stromal tumor(GIST).CASE SUMMARY A 47-year-old Caucasian woman,who had undergone splenectomy for trauma at the age of 16,underwent gastroscopy for long-lasting epigastric pain and dyspepsia.It revealed a 15 mm submucosal nodule bulging into the gastric lumen with smooth margins and normal overlying mucosa.A thoraco-abdominal computed tomography scan showed in the gastric fundus a rounded mass(30 mm in diameter)with an exophytic growth and intense enhancement after administration of intravenous contrast.Endoscopic ultrasound scan showed a hypoechoic nodule,and fine needle FNA was inconclusive.Gastric GIST was considered the most probable diagnosis,and surgical resection was proposed due to symptoms.A laparoscopic gastric wedge resection was performed.The postoperative course was uneventful,and the patient was discharged on the seventh postoperative day.The final pathology report described a rounded encapsulated accumulation of lymphoid tissue of about 4 cm in diameter consistent with spleen parenchyma implanted during the previous splenectomy.CONCLUSION Splenosis is a rare condition that should always be considered as a possible diagnosis in splenectomized patients who present with an intramural gastric nodule.
文摘Thoracic splenosis is the autotransplantation of splenic tissue in the left thoracic cavity as a result of a splenic injury. This rare pathology is usually asymptomatic and may be discovered on incidental imaging, but the diagnosis often requires invasive procedures such as surgery in order to eliminate a neoplasic origin. We report a rare symptomatic case of a 39-year-old man presenting with chest pain and multiple nodules revealed on a computed tomography scan. The patient underwent a surgical exploration and the pathological studies concluded to a thoracic splenosis. Indeed, the previous medical history of the patient revealed a left thoraco-abdominal traumatism during childhood. The aim of this paper is to emphasize that the diagnosis can now be performed using only imaging techniques such as technetium-99 sulfur colloid or labelled heat-denatured red blood cell scintigraphy to avoid unnecessary invasive procedures including thoracotomy.
文摘A 61-year-old man with locally advanced prostate cancer was found to have multiple solid intra-abdominal solid lesions during staging investigations.While some were in the pelvis,they were not located in the common landing sites for prostate cancer metastases,and his prostate specific antigen was not significantly elevated to suggest a high burden of metastatic disease.He reported a history of a blunt abdominal trauma due to a motor vehicle accident more than forty years ago which had been conservatively managed.His staging imaging revealed a lack of a discrete spleen in his left upper abdomen and this raised the suspicion that these solid lesions may represent ectopic splenic tissue.Imaging with nuclear medicine scintigraphy confirmed the lesions in his upper abdomen and pelvis to be splenunculi.He proceeded with a combination of androgen deprivation therapy and external beam radiotherapy for locally advanced,non-metastatic prostate cancer.Although it has been described in patients with low risk prostate cancer,this is the first case report of splenunculi mimicking metastases in a patient with locally advanced prostate cancer.
