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2017 ; 96
(29
): e7552
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Thoracic splenosis mimicking a pleuropneumonia: A case report
#MMPMID28723778
Baldolli A
; Coeuret S
; Le Pennec V
; Agostini D
; Verdon R
Medicine (Baltimore)
2017[Jul]; 96
(29
): e7552
PMID28723778
show ga
RATIONALE: Splenosis is the development of one or more heterotopic splenic tissue
autoimplants following rupture of the spleen and remains mostly asymptomatic.
PATIENT CONCERNS: We report a case of a 50-year old post-traumatic splenectomized
man admitted for a left side community acquired pneumonia resistant to
antibiotics. DIAGNOSES: The diagnosis of intrathoracic ectopic spleen was
suspected because of the history of spleen trauma with diaphragm rupture and the
absence of Howell-Jolly bodies. INTERVENTIONS: Technetium (Tc)-m colloid
scintigraphy SPECT, fused with CT scan showed an intense radionuclide uptake on
hyper vascularized masses without any additional pathologic uptake and confirmed
the diagnosis of thoracic splenosis. OUTCOMES: Despite any lifelong penicillin
prophylaxis, he had no history of infections eight years after the diagnosis.
LESSONS: Physician must be aware of this differential diagnosis and of its
consequences. Depending on its size and location, it may lead to incorrect
diagnosis (tumor, empyema, abscess ...), treatment and invasive procedures while
the diagnosis of splenosis only relies upon imaging studies associated with
functionnal study of the uptake of particles or cells.