Varghese Jerrin, Bergson Jill, Yaipen Omar
Department of Radiology, Northport VA Medical Center, Northport.
Hofstra University, Hempstead, NY.
J Comput Assist Tomogr. 2018 Sep/Oct;42(5):730-731. doi: 10.1097/RCT.0000000000000762.
We describe the case of a 50-year-old man with history of remote splenectomy who underwent routine lung cancer screening chest computed tomography and was incidentally found to have a liver lesion. Dedicated liver protocol computed tomography demonstrated "archiform" enhancement pattern in the arterial phase and homogenous filling-in enhancement on portal venous and delayed phases. Multiple other smaller enhancing intraperitoneal lesions were also found. These findings along with history of splenectomy confirmed a diagnosis of intrahepatic and intraperitoneal splenosis and helped avoid biopsy. Intrahepatic splenules can be challenging to diagnose owing to its unusual location and similarity in appearance to a liver neoplasm or metastasis. However, careful evaluation of enhancement pattern and review of medical history can lead to an accurate diagnosis and avoidance of invasive biopsy.
我们描述了一名50岁男性的病例，该患者有脾切除术史，接受了常规肺癌筛查胸部计算机断层扫描，偶然发现肝脏有病变。肝脏专用协议计算机断层扫描显示动脉期呈“拱形”强化模式，门静脉期和延迟期呈均匀填充强化。还发现了其他多个较小的腹腔内强化病变。这些发现以及脾切除术史证实了肝内和腹腔内脾组织植入的诊断，并有助于避免活检。肝内脾小结由于其不寻常的位置以及外观与肝脏肿瘤或转移瘤相似，诊断可能具有挑战性。然而，仔细评估强化模式并回顾病史可导致准确诊断并避免进行侵入性活检。
