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 parasitizes 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 hemoptysis.
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.
- 1. Walker CM, Takasugi JE, Chung JH, Reddy GP, Done SL, Pipavath SN, Schmidt RA, Godwin JD. Tumorlike conditions of the pleura. Radiographics : a review publication of the Radiological Society of North America, Inc. 32 (4): 971-85. doi:10.1148/rg.324115184 - Pubmed
- 2. Huang AH, Shaffer K. Case 93: thoracic splenosis. Radiology. 239 (1): 293-6. doi:10.1148/radiol.2391040056 - Pubmed
- 3. Madjar S, Weissberg D. Thoracic splenosis. Thorax. 49 (10): 1020-2. Pubmed
- 4. Lopes B, Almeida LR, Vicente AA, Marcellos DC, Corassa M, Romano RF, Freire F. Thoracic splenosis as a differential diagnosis of juxtapleural nodules. Respiratory medicine case reports. 11: 1-3. doi:10.1016/j.rmcr.2013.10.001 - Pubmed
- 5. Singh P, Munn NJ, Patel HK. Thoracic splenosis. The New England journal of medicine. 333 (13): 882. doi:10.1056/NEJM199509283331318 - Pubmed
- 6. Normand JP, Rioux M, Dumont M, Bouchard G, Letourneau L. Thoracic splenosis after blunt trauma: frequency and imaging findings. AJR. American journal of roentgenology. 161 (4): 739-41. doi:10.2214/ajr.161.4.8372748 - Pubmed
- 7. Moncada R, Williams V, Fareed J, Messmore H. Thoracic splenosis. AJR. American journal of roentgenology. 144 (4): 705-6. doi:10.2214/ajr.144.4.705 - Pubmed