SHM Converge Scientific Abstract ePoster Gallery-The Answer Lies in the History:a Case of Thoracic Splenosis

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This case report highlights thoracic splenosis (TS), a rare benign condition in which splenic tissue autotransplants into the thorax after splenic trauma or splenectomy, often with associated diaphragmatic injury. A 50-year-old woman with a remote history of splenectomy after a motor vehicle accident was found incidentally to have left pleural-based lung masses on CT abdomen. She had no respiratory symptoms and no significant environmental exposure history. CT chest with contrast showed homogeneously enhancing left pleural implants suspicious for thoracic splenosis. The diagnosis was confirmed with a technetium-99m sulfur colloid liver/spleen scan, which demonstrated increased uptake in the left hemithorax and abdomen, consistent with intrathoracic and abdominal splenosis.<br /><br />The report emphasizes that TS is frequently discovered incidentally, often decades after the original trauma, and may mimic malignancy on imaging. Although thoracic splenosis is uncommon, it should be considered in patients with left-sided pleural or pulmonary nodules and a history of splenic injury or surgery. Detailed remote medical history is essential because it can prevent unnecessary invasive testing such as biopsy or thoracotomy.<br /><br />Nuclear medicine imaging plays a key role in diagnosis. While 99mTc heat-damaged red blood cell scanning is considered the gold standard, technetium-99m sulfur colloid scanning is a practical, reliable, and more readily available alternative. Management is usually conservative, with surgery reserved only for symptomatic patients or when cancer cannot be confidently excluded.<br /><br />Overall, the case reinforces that careful history-taking and appropriate noninvasive imaging are crucial to avoiding misdiagnosis and unnecessary intervention in thoracic splenosis.

Asset Subtitle

Shobhna Singh

Meta Tag

Author List Ankita Agarwal, Shobhna Singh

Category Clinical Vignettes

Concept Thoracic Splenosis

Concept Remote Medical History

Concept Technetium-99m Heat-Damaged Red Cell Scan

Concept Technetium-99m Sulfur Colloid Scan

Concept Splenic Trauma

Distinguished Non-Finalist

Presenter Organization Emory Saint Joseph's Hospital

Presenting Author Shobhna Singh

Track Adult

Keywords

thoracic splenosis

splenic trauma

splenectomy

diaphragmatic injury

pleural nodules

lung masses

technetium-99m sulfur colloid scan

nuclear medicine imaging

incidental finding

benign condition

Thoracic Splenosis

Remote Medical History

Technetium-99m Heat-Damaged Red Cell Scan

Technetium-99m Sulfur Colloid Scan

Splenic Trauma