Accessory spleen mimicking pancreatic tumour: evaluation by 99mTc-labelled colloid SPECT/CT study. Report of two cases and a review of nuclear medicine methods utility

• Autorzy: Pachowicz M. , Mocarska A. , Staroslawska E. , Pietrzyk L. , Chrapko B.
• Języki publikacji: EN

Abstrakty

EN

The accessory spleen is a common congenital anomaly, typically asymptomatic and harmless to the patient. However, in some clinical cases, this anomaly becomes significant as it can be mistaken for a tumour or lymph node and be missed during a therapeutic splenectomy. There are nuclear medicine modalities which can be applied in the identification and localisation of an accessory spleen. They include scintigraphy with radiolabelled colloids or heat damaged red blood cells, which are trapped in the splenic tissue. Modern techniques, including hybrid imaging, enable simultaneous structure and tracer distribution evaluations. Additionally, radiation-guided surgery can be used in cases where the accessory spleen, which is usually small (not exceeding 1 cm) and difficult to find among other tissues, has to be removed. In the study, we would like to present 2 cases of patients in which the malignancy had to be excluded for the reason that the multiple accessory spleens were very closely related to the pancreas. There was a lack of certainty in the multi-phase computed tomography (CT) evaluation; however, this situation was clearly resolved by using the ⁹⁹ᵐTc-stannous colloid single photon emission computed tomography/ CT study. We would also like to briefly analyse the clinical applications of nuclear medicine in case of an accessory spleen. (Folia Morphol 2015; 74, 4: 532–539)

• Wydawca: -
• Czasopismo: Folia Morphologica
• Rocznik: 2015
• Tom: 74
• Numer: 4
• Opis fizyczny: p.532-539,fig.,ref.

Twórcy

autor

Pachowicz M.

• Chair and Department of Nuclear Medicine, Medical University of Lublin, Poland
• Department of Didactics and Medical Simulation, Medical University of Lublin, Poland

autor

Mocarska A.

• St. John’s Cancer Centre, Lublin, Poland

autor

Staroslawska E.

• St. John’s Cancer Centre, Lublin, Poland

autor

Pietrzyk L.

• Department of Didactics and Medical Simulation, Medical University of Lublin, Poland
• General and Minimally Invasive Surgery Department, 1st Clinical Military Hospital, Lublin, Poland

autor

Chrapko B.

• Chair and Department of Nuclear Medicine, Medical University of Lublin, Poland

Bibliografia

• 1. Antevil J, Thoman D, Taller J, Biondi M (2002) Laparoscopic accessory splenectomy with intraoperative gamma probe localization for recurrent idiopathic thrombocytopenic purpura. Surg Laparosc Endosc Percutan Tech, 12: 371–374.
• 2. Barawi M, Bekal P, Gress F (2000) Accessory spleen: a potential cause of misdiagnosis at EUS. Gastrointest Endosc, 52: 769–772.
• 3. Bhalani VV, Hecht H, Sachs P, King M (2012) Thoracic splenosis: noninvasive diagnosis using Technetium-99 sulfur colloid. Conn Med, 76: 585–587.
• 4. Franceschetto A, Casolo A, Cucca M, Bagni B (2006) Splenosis: 99mTc-labelled colloids provide the diagnosis in splenectomised patients. Eur J Nucl Med Mol Imag, 33: 1102.
• 5. Gayer G, Hertz M, Strauss S, Zissin R (2006) Congenital anomalies of the spleen. Semin Ultrasound CT MR, 27: 358–369.
• 6. Groshar D, Bernstine H, Goldberg N, Stern D, Sosna J (2010) Accessory spleen-like masses in oncology patients: Are they always benign? World J Radiol, 2: 368–373.
• 7. Kim SH, Lee JM, Han JK, Lee JY, Kim KW, Cho KC, Choi BI (2008) Intrapancreatic accessory spleen: findings on MR Imaging, CT, US and scintigraphy, and the pathologic analysis. Korean J Radiol, 9: 162–174. doi: 10.3348/kjr.2008.9.2.162.
• 8. Moore KL, Dalley AF, Agur AMR (ROK????). Clinically oriented anatomy. 6th Ed. Wolters Kluwer. Lippincott Williams & Wilkins.
• 9. Morris KT, Horvath KD, Jobe BA, Swanstrom LL (1999) Laparoscopic management of accessory spleens in immune thrombocytopenic purpura. Surg Endosc, 13: 520–522.
• 10. Spencer LA, Spizarny DL, Williams TR (2010) Imaging features of intrapancreatic accessory spleen. Br J Radiol, 83: 668–673.
• 11. Sty JR, Conway JJ (1985) The spleen: development and functional evaluation. Semin Nucl Med, 15: 276–298.
• 12. Toutziaris Ch, Kampantais S, Christopoulos P, Papaziogas B, Vakalopoulos I (2013) Compensatory enlargement of an accessory spleen mimicking a retroperitoneal tumor: a case report. Hippokratia, 17: 185–186.
• 13. Unver Dogan N, Uysal II, Demirci S, Dogan KH, Kolcu G (2011). Accessory spleens at autopsy. Clin Anat, 24: 757–762.
• 14. Wang G, Chen P, Zong L (2014) Accessory spleen arising from the gastric fundus mimicking gastrointestinal stromal tumor following splenectomy: a case report. Exp Ther Med, 7: 349–351.
• 15. Yildiz AE, Ariyurek MO, Karcaaltincaba M (2013) Splenic anomalies of shape, size, and location: pictorial essay. Scientific World J, 2013: 321810.

Identyfikatory

DOI

10.5603/FM.2015.0119