Very Rare Finding of Thoracic Splenosis-Case Report

Vedran Cesarec, Željko Djaković, Tomislav Bečejac, Goran Madžarac, Ivan Bunjevac, Dorian Hiršl, Dubravko Jalšovec, Marko Vrančić, Zoran Janevski, Dinko Stančić-Rokotov

Clinic for thoracic surgery Jordanovac, University hospital center, Zagreb, Croatia

Date, time and location: 2018.05.25 10:30, Press Hall, 2F

Abstract

Objective:

There are very small number of published case reports of thoracic splenosis so far. Thoracic splenosis is always located in the left hemithorax, occurring after simultaneous trauma of spleen and diaphragm, when the autotransplantation of splenic tissue into the pleural cavity is happened.

Methods:

We present a case of 74-year old man with lasting pain in the right upper abdomen. In medical history we found out that 40 years ago the patient fell from the height and right after the accident splenectomy was performed. Diagnostic evaluation due to abdominal pain was performed and on radiological exams an incidental finding of subpleural masses in left hemithorax is noticed. On the PET-CT multiple nodal subpleural changes in left pleural cavity and multiple nodosal changes in left hemiabdomen of unknown origin were found with slightly enhanced FDG metabolism. Patient was referred to thoracic surgery department to clarify diagnosis.The left-sided uniportal VATS was performed and multiple subpleural purple colored nodules (much more are seen operatively than detected on radiological exams) were found. Wedge resections of both lung lobes were made.

Results:

Postoperative histopathological exam confirmed the diagnosis of thoracic splenosis.

Conclusions:

When an infiltration of the lung on radiological examination is seen, one of the first thoughts is malignancy. Maybe the key point for suspicion of thoracic splenosis is traumatic event in patient’s history. Early identification of abdominal or left low thoracic trauma in the past as possible cause of thoracic splenosis can sometimes prevent unnecessary invasive procedures, such as biopsy or surgery. Fortunately, thoracic splenosis is a benign condition in which no further therapy is needed.