Presentation
Pleural masses for investigation. MVA over ten years ago.
Patient Data
Multiple lobulated pleurally based masses are seen within the left hemithorax on low dose CT. There is intense uptake of Tc99m labelled red blood cells by these pleural masses. Several smaller avid soft tissue deposits are seen in the upper abdomen. The spleen is surgically absent.
Case Discussion
At the time of MVA, the patient suffered a severe splenic injury with diaphragmatic rupture. The defect was repaired and splenectomy performed. At the time of the injury, there was seeding of splenic tissue into the thorax which grew over time in the absence of the normal spleen.
Thoracic splenosis can mimic more sinister diagnoses such as primary or secondary pleural neoplastic disease. Nuclear medicine heat-damaged red cell scans are highly accurate for diagnosing splenosis, demonstrating sequestered red blood cells within the ectopic splenic tissue.