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: 78
Gender: Female

A nodular lesion in the tail of pancreas that had been found incidentally on an abdominal CT for other purpose. 

Intravenous contrast in the arterial phase shoes better the ovoid lesion that appears more dense 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.

Special formatting for emphasis on pancreatic nodule. A nodular lesion in the tail of pancreas that had been found incidentally on an abdominal CT for other purpose. 

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 is perhaps not as rare as previously thought. In fact, in 3000 autopsies reported by Halpert and colleagues 364 accessory spleens were found and, in 17% of cases, 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 a number of 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. 

PlayAdd to Share

Case information

rID: 18874
Case created: 26th Jul 2012
Last edited: 8th Sep 2015
Inclusion in quiz mode: Included

Updating… Please wait.
Loadinganimation

Alert accept

Error Unable to process the form. Check for errors and try again.

Alert accept Thank you for updating your details.