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Vol. 57. Issue 5.
Pages 369 (May 2021)
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Vol. 57. Issue 5.
Pages 369 (May 2021)
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Thoracic Splenosis, a Challenging Diagnosis
Esplenosis torácica, un diagnóstico complejo
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Maria João Araújo
Corresponding author
mariajoaoaraujo11@gmail.com

Corresponding author.
, João Cunha, Lurdes Ferreira
Pulmonology Department, Hospital de Braga, Braga, Portugal
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Splenosis is a benign condition characterized by ectopic splenic tissue following traumatic rupture of the spleen or splenectomy.1 Thoracic splenosis is rare and almost exclusively present in the left hemithorax. Patients are usually asymptomatic, and it is most commonly an incidental finding.2 Diagnosis is challenging as the multiple nodules could mimic malignancy and because there is a long interval between initial trauma and diagnosis.1 Management is expectant except in symptomatic patients or whenever the diagnosis of splenosis is unclear.2

A 66-year-old male with a history of splenectomy after a car accident presented 40 years later with asymptomatic opacities in the left hemithorax on routine chest radiography. Chest computed tomography (CT) showed scattered nodules in the left pleura, in the mediastinum, in the left posterior chest wall, medial to the liver, at the previous splenic site and in the left diaphragm (Fig. 1A). SPECT/CT with technetium (Tc)-99m showed increased uptake by the same nodular formations (Fig. 1B). History and the preferential distribution of the nodules in the left hemithorax and the presence of splenic orthotopic spleen tissue were sufficient to establish the diagnosis of thoracic and abdominal splenosis. Given the asymptomatic state, conservative treatment and follow-up was performed.

Fig. 1
(0.11MB).
References
[1]
T. Ferrer Marrero, V. Prieto-Centurion, H. Jaffe.
Thoracic splenosis: history is the key.
Respir Med Case Rep, 22 (2017), pp. 251-253
[2]
A. O-Yurvati, J. Thompson, T. Woods.
Thoracic splenosis more than 40 years after thoracoabdominal trauma.
J Am Osteop Assoc, 113 (2013), pp. 853-856
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