open access

Vol 74, No 4 (2015)
CASE REPORTS
Published online: 2015-11-27
Submitted: 2014-08-31
Accepted: 2015-01-13
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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

M. Pachowicz, A. Mocarska, E. Starosławska, Ł. Pietrzyk, B. Chrapko
DOI: 10.5603/FM.2015.0119
·
Pubmed: 26620518
·
Folia Morphol 2015;74(4):532-539.

open access

Vol 74, No 4 (2015)
CASE REPORTS
Published online: 2015-11-27
Submitted: 2014-08-31
Accepted: 2015-01-13

Abstract

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.

Abstract

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.

Get Citation

Keywords

accessory spleen, SPECT/CT, radiolabelled colloid, radiolabelled red blood cells, splenosis, radiation guided surgery

About this article
Title

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

Journal

Folia Morphologica

Issue

Vol 74, No 4 (2015)

Pages

532-539

Published online

2015-11-27

DOI

10.5603/FM.2015.0119

Pubmed

26620518

Bibliographic record

Folia Morphol 2015;74(4):532-539.

Keywords

accessory spleen
SPECT/CT
radiolabelled colloid
radiolabelled red blood cells
splenosis
radiation guided surgery

Authors

M. Pachowicz
A. Mocarska
E. Starosławska
Ł. Pietrzyk
B. Chrapko

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