Large accessory spleen

Case contributed by Mostafa Elfeky
Diagnosis almost certain


Left loin/flank pain

Patient Data

Age: 10 years
Gender: Male

CT abdomen with contrast


Sizable left abdominal mass lesion is noted with well-defined lobulated margins, extending from the level of the tail of the pancreas to the level of the inferior pole of the left kidney. It measures 6.7 x 6.1 x 10.1 cm in AP, SS and CC dimensions respectively. It is insinuated in between the pancreas, spleen, left kidney, stomach and bowel. It is abutting the left psoas muscle. It is of soft tissue density with heterogeneous patchy enhancement comparable to the splenic pattern of enhancement.

The mass is inseparable from the tail of pancreas. The left adrenal gland is displaced medially, separable from the lesion with no focal lesion. Right and left adrenal glands are normal. It has arterial supply from branches splenic artery.

The spleen is normal in site, size and shape with no focal lesion.

Case Discussion

This case demonstrates a large mass lesion at the left side of the abdominal cavity with the same enhancing characteristic pattern of the spleen ("tigroid pattern"). It is also supplied by branches from the splenic artery. It is inseparable from the pancreatic tail which is also one of the sites of splenules. All these features made the diagnosis of accessory spleen the most likely possibility rather than a primary lesion.

How to use cases

You can use Radiopaedia cases in a variety of ways to help you learn and teach.

Creating your own cases is easy.

Updating… Please wait.

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

 Thank you for updating your details.