Thoracic splenosis refers to autotransplantation of splenic tissue into the pleural space which typically occurs after trauma. It may occur in approximately 18% of patients with combined diaphragmatic and splenic injuries and is more common after penetrating injuries.
Splenic tissue may enter the left pleural space through a diaphragmatic tear or a congenital defect and parasitises blood supply from the pleura, chest wall, or diaphragm.
There is a greater left sided predilection due to the spleen being on the left.
Thoracic splenosis is usually asymptomatic and thus is usually an incidental finding at imaging performed for other reasons. It may rarely cause chest pain or haemoptysis.
Treatment and prognosis
Management is expectant in almost all cases where surgery is considered only indicated in occasional symptomatic patients and in situations where diagnosis is doubtful and when it is not possible to exclude malignancy. Nodule resection is genrally meant to be avoided due to procedure risk as well as possible theoretical protection against post-splenectomy sepsis.
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