Thoracic splenosis: a case report and the importance of clinical history

J Korean Med Sci. 2010 Feb;25(2):299-303. doi: 10.3346/jkms.2010.25.2.299. Epub 2010 Jan 19.

Abstract

We present a case of thoracic splenosis in a 42-yr-old man with a medical history of abdominal surgery for a penetration injury with an iron bar of the left abdomen and back. He had been in good condition, but a chest radiograph taken during a regular checkup showed a multinodular left pleura-based mass. Computed tomography (CT) showed that the mass was well-enhanced and homogeneous, indicating a sclerosing hemangioma. Following its removal by video-assisted thoracoscopic surgery, the mass appeared similar to a hemangioma, with marked adhesion to the left side diaphragmatic pleura and lung parenchyma. Frozen section showed that the lesion was a solid mass consisted with abundant lymphoid cells, suggesting a low grade lymphoma. On permanent section, however, the mass was found to be composed of white pulp, red pulp, a thick capsule and trabeculae and was diagnosed as ectopic splenic tissue, or thoracic splenosis. Review of the patient's history and chest CT at admission revealed that the patient had undergone a splenectomy for the penetration injury 20 yr previously.

Keywords: Splenectomy; Splenosis; Thoracic Cavity.

Publication types

  • Case Reports

MeSH terms

  • Abdominal Injuries / complications
  • Adult
  • Diagnosis, Differential
  • Humans
  • Male
  • Medical Records
  • Spleen / injuries
  • Spleen / surgery
  • Splenectomy
  • Splenosis / diagnosis*
  • Splenosis / diagnostic imaging
  • Splenosis / etiology
  • Thoracic Diseases / diagnosis*
  • Thoracic Diseases / diagnostic imaging
  • Thoracic Diseases / etiology
  • Thoracic Surgery, Video-Assisted
  • Tomography, X-Ray Computed