Khan Amir M, Manzoor Kamran, Gordon David, Berman Andrew
Department of Pulmonary, Jacobi and Montefiore Medical Center, Albert Einstein College of Medicine, New York, USA.
Respirology. 2008 May;13(3):481-3. doi: 10.1111/j.1440-1843.2008.01272.x.
Thoracic splenosis (TS) is autoimplantation of ectopic splenic tissue in the thoracic cavity that occurs following splenic injury. The majority of cases of TS are asymptomatic and are diagnosed in the course of an evaluation of incidentally discovered pulmonary lesions. Some cases may be difficult to diagnose, especially if features suggesting TS are not recognized. This may lead to an extensive work-up and unnecessary invasive diagnostic procedures including thoracotomy. This case report describes a 40-year-old man, who was diagnosed incidentally with TS, several years after the initial injury. Multiple, asymptomatic, left-sided pleural based lesions associated with a history of thoracoabdominal injury and splenectomy are the key points that should alert suspicion of TS, which can then simply be confirmed by a Tc-99m sulphur colloid radionuclide scan. Most patients are treated conservatively unless they are symptomatic. Physicians must recognize the key features suggesting a diagnosis of TS, order appropriate imaging studies and avoid unnecessary invasive diagnostic procedures.
胸腔内脾组织异位种植（TS）是指脾损伤后胸腔内出现异位脾组织的自体移植现象。大多数TS病例无症状，是在对偶然发现的肺部病变进行评估过程中被诊断出来的。有些病例可能难以诊断，尤其是在未识别出提示TS的特征时。这可能导致广泛的检查以及包括开胸手术在内的不必要的侵入性诊断程序。本病例报告描述了一名40岁男性，在初次受伤数年之后偶然被诊断为TS。多个无症状的、位于左侧胸膜的病变，伴有胸腹损伤和脾切除病史，是应引起对TS怀疑的关键点，然后通过锝-99m硫胶体放射性核素扫描即可简单确诊。除非有症状，大多数患者采取保守治疗。医生必须认识到提示TS诊断的关键特征，安排适当的影像学检查，并避免不必要的侵入性诊断程序。
