CTICasesMediastinal Splenosis
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Imaging findings
Chest radiograph demonstrates a subtle nodule adjacent to the left heart border. Subsequent contrast-enhanced CT shows multiple well-defined pleural-based lesions along the left mediastinal pleura and pericardium, as well as the absence of the spleen in the left upper quadrant. A technetium-99m sulfur colloid liver-spleen scan (SPECT) confirms diagnosis by showing clear, intense uptake within the pleural lesions.
Key takeaways
Splenosis is the autotransplantation of splenic tissue, most commonly occurring within the peritoneal cavity following traumatic splenic rupture or surgery. Thoracic or mediastinal splenosis is a rare manifestation resulting from concurrent diaphragmatic injury, and recognizing the absence of the native spleen alongside characteristic uptake on a liver-spleen scan is diagnostic, avoiding unnecessary invasive biopsy.
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