open access
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
open access
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.
Keywords
accessory spleen, SPECT/CT, radiolabelled colloid, radiolabelled red blood cells, splenosis, radiation guided surgery
About this articleTitle
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
Issue
Article type
Case report
Pages
532-539
Published online
2015-11-27
Page views
1292
Article views/downloads
3681
DOI
10.5603/FM.2015.0119
Pubmed
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
