Selected images from initial abdomen CT
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View second image(si). Planar images
View third image(si). Selected axial images (SPECT)
Full history/Diagnosis is available below
Splenic imaging: Images of the abdomen show multiple foci of radiotracer activity in the left upper quadrant, adjacent to the superior pole of the right kidney, adjacent to the inferior tip of the right lobe of the liver, and two smaller faint foci in the mid abdomen region
All of these lesions correlate with multiple homogeneously enhancing nodular masses seen on the CT performed at Mallinckrodt Institute of Radiology.Additional planar images of the thorax were obtained which demonstrate no increased radiotracer activity in the thorax.
Splenosis itself may induce relapse of hematologic diseases, mainly autoimmune thrombocytopenia. Given that multiple presumed splenules were identified in the left upper quadrant in this patient, a heat damaged red blood scan is the ideal study to determine the nature of the right upper quadrant lesion.
Since the splenules in the left upper quadrant will expectedly take up the heat-damaged red blood cells, an internal comparison was available to evaluate the nature of right upper quadrant mass. A confirmatory imaging pattern will eliminate the need for any invasive tests such as a needle biopsy.
Hagman TF, Winer-Muram HT, Meyer CA, Jennings SG. Intrathoracic splenosis: superiority of technetium Tc 99m heat-damaged RBC imaging. Chest. 2001 Dec;120(6):2097-8.
View followup image(mc). Comparison of selected contrast-enhanced abdomen CT images and heat damaged RBC SPECT study.
Based on combined CT and NM findings: Splenosis.
References and General Discussion of Spleen Imaging (Anatomic field:Vascular and Lymphatic Systems, Category:Effect of Trauma)
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