Medical Department I, University Hospital of Schleswig-Holstein, Building A, Ratzeburger Allee 160, 23562, Lübeck, Germany.
Institute of Nutritional Medicine, University of Lübeck, Ratzeburger Allee 160, 23562, Lübeck, Germany.
J Med Case Rep. 2022 Feb 19;16(1):73. doi: 10.1186/s13256-022-03288-9.
Splenosis is the heterotopic autotransplantation of splenic tissue after severe splenic trauma and/or splenectomy. The epidemiology is elusive, but splenosis is frequently misdiagnosed as malignant tumors of gastrointestinal, gynecological, or hematological origin before the correct diagnosis is ultimately found. We herein report a rare case of combined, extensive intraabdominal and intrathoracic splenosis initially presenting as pleural mesothelioma.
A 63-year-old Caucasian male presented with dyspnea and recurring thoracic pain. Initial X-ray and computed tomography scans showed disseminated intrathoracic and intraabdominal lesions. Consequently, thoracoabdominal mesothelioma or a polytopically metastasized cancer of unknown origin was suspected. A thorough examination of the patient's medical history and contrast-enhanced ultrasound by a skilled examiner revealed the diagnosis of extensive abdominal and thoracic splenosis as a consequence of an abdominal gunshot wound with a ruptured diaphragm several decades earlier. Timely diagnosis by noninvasive measures prevented the patient from potential complications of harmful diagnostic procedures, including nuclear imaging and biopsies. The patient is currently treated for hepatitis C and chronic obstructive lung disease, whereas no specific treatment for splenosis is required.
We present a case of rare intrathoracic and intraperitoneal splenosis mimicking mesothelioma. Contrast-enhanced ultrasound and thorough patient history were used for diagnosis and prevented this patient from having to undergo potentially harmful diagnostics. Splenosis can occur after splenic trauma and, consequently, needs to be considered as a rare differential diagnosis to malignant tumors of various origins when a matching patient history is obtained.
脾组织在严重脾外伤和/或脾切除术后发生的异位自体移植称为脾种植。其流行病学难以捉摸，但在最终明确诊断之前，脾种植常被误诊为胃肠道、妇科或血液系统来源的恶性肿瘤。我们在此报告一例罕见的合并性、广泛的腹腔内和胸腔内脾种植，最初表现为胸膜间皮瘤。
一名 63 岁的白人男性因呼吸困难和反复胸痛就诊。初始 X 射线和计算机断层扫描显示弥漫性胸内和腹腔内病变。因此，怀疑为胸腹部间皮瘤或多部位转移性癌症，来源不明。通过熟练检查者对患者的病史和增强超声进行全面检查，提示广泛的腹部和胸部脾种植是几十年前腹部枪伤导致膈肌破裂的结果。通过非侵入性措施及时诊断，避免了患者进行潜在有害的诊断程序，包括核成像和活检。目前，该患者正在接受丙型肝炎和慢性阻塞性肺病的治疗，而无需针对脾种植进行特定治疗。
我们报告了一例罕见的胸腔内和腹腔内脾种植，模拟间皮瘤。增强超声和全面的患者病史用于诊断，并避免了该患者进行潜在有害的诊断。脾种植可在脾外伤后发生，因此当获得匹配的患者病史时，需要将其作为各种来源的恶性肿瘤的罕见鉴别诊断。
