Intrapancreatic accessory spleen mimicking a pancreatic endocrine tumour

Case contributed by Dr Bruno Di Muzio

Presentation

CT examination to search for gastrointestinal disorders.

Patient Data

Age: 80 years
Gender: Female

There is a well-defined nodular lesion in the tail of pancreas. The intravenous contrast in the arterial phase better demonstrates the ovoid lesion that appears denser than the adjacent pancreatic tissue. It is noticed that the pattern of enhancement and attenuation of the nodule are similar to the spleen. No rapid washout pattern was characterized in the arterial phase.

A nodular lesion in the tail of pancreas that had been found incidentally.

Case Discussion

Posterior approach with single photon emission CT with technetium 99–labelled red blood cells confirmed that it was an accessory spleen. Normal hormone levels were found.

Intrapancreatic accessory spleen it is not that uncommon, with an autopsy study with 3000 subjects finding accessory spleens in 364 and, in 17% of those, it was located in the tail of the pancreas 1.

Endocrine tumours of the pancreas comprise tumours which arise from the pancreatic islet cells and include some distinct tumours which match the cell type of origin. Each has different clinical presentation, on account of them elaborating various hormones and different biological behaviours. 

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Case information

rID: 18874
Published: 26th Jul 2012
Last edited: 16th Jul 2018
Inclusion in quiz mode: Included

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