Diagnosis of Thoracic Splenosis by Contrast-Enhanced Ultrasound (CEUS)

Introduction

Splenic injuries occur in up to 30% of cases of abdominal trauma (A. El-Menyar et al. World J Surg 2017; 41: 2689–2696) and can lead to secondary splenic tissue metastasis in up to 65% of cases, depending on the extent of the injury (J. Normand et al. Am J Roentgenol. 1993;161:4, 739–41). This phenomenon, which is called splenosis, can result in differential diagnostic difficulties. In the case of an associated diaphragmatic injury, displacement and de novo formation of splenic tissue in the thoracic cavity is possible (F. Le Bars et al. Chin J Traumatol 2020; 3; 185–86). In a single study, the incidence of thoracic splenosis in patients with splenic and concomitant diaphragmatic injury was described in 3 of 18 cases (18%) (J. Normand et al. Am J Roentgenol. 1993;161:4, 739–41).

To date, thoracic splenosis has only been mentioned casuistically, and the diagnosis of malignant thoracic masses is usually established by histology. Contrast-enhanced ultrasonography (CEUS) allows characterization and thus identification of splenic tissue (PS. Sidhu et al. Ultraschall in Med 2018; 39: e2–e44). This case report describes for the first time the primary diagnosis of intrathoracic splenosis by CEUS.

Publication History

Received: 13 April 2022

Accepted after revision: 09 August 2022

Article published online:
05 September 2022