The (re)generation of splenic tissue

Summary A 48-year-old man with a history of a traumatic splenic rupture followed by splenectomy at the age of 5 years was referred to the outpatient clinic with markedly elevated liver enzymes. He was diagnosed with alcoholic liver cirrhosis. Ultrasound of the upper abdomen revealed hepatomegaly and suggested a central mass in the liver. Subsequent MRI of the abdomen did not show a hepatic mass, but revealed multiple intraperitoneal and retroperitoneal ovoid structures with a maximum diameter of 3 cm. A peripheral blood smear did not reveal Howell-Jolly bodies suggesting intact splenic function. The diagnosis splenosis—that is, autotransplantation of splenic tissue after iatrogenic/traumatic rupture of the spleen—was considered and confirmed by SPECT-CT with technetium-99m ( 99m Tc) labelled heat-denatured autologous red blood cells. BACKGROUND Splenosis is an acquired condition defined as autotransplantation of viable splenic tissue throughout different anatomic compartments of the body. Abdominal splenosis (AS) is estimated to occur in 65% of traumatic splenic ruptures with an average interval between trauma and splenosis of more than 10 years. The phenomenon is not well known among physicians. Usually, splenosis requires no treatment, but the diagnosis is warranted to exclude metastasised malignancy and to assess splenic function.