Thoracic splenosis

Case contributed by Stefan Tigges

Presentation

Shortness of breath, prior gun shot chest/abdomen.

Patient Data

Age: 40 years
Gender: Female
X-ray

Right internal jugular catheter tip in the superior vena cava, no pneumothorax. Lobulated left apical pleural-based mass, mild left pleural thickening. Bullet fragment projects over lower thoracic spine.

CT

Bullet fragment within the T9 vertebral body. Diffuse nodular thickening left pleura with a small spleen. Multiple soft tissue nodules left upper lateral abdominal wall.

Case Discussion

The lower thoracic/upper abdominal findings have been stable for over four years compared to a prior abdominal CT scan (not shown). There was no history of malignancy. Given the known prior gunshot injury, a presumptive diagnosis of splenosis involving the left pleura and left abdominal wall was made.

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