CTICasesIntrahepatic Splenosis Mimicking Hepatocellular Carcinoma
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Imaging findings
Chest and abdominal CT scans show hyper-enhancing, exophytic soft tissue masses along the hepatic dome and adjacent to the left diaphragm. The lesions are surrounded by a thin, persistent rim of fat, suggesting they are extrahepatic and compressing the liver. Spleen is absent from the left upper quadrant. Biopsy of the masses demonstrates normal splenic tissue, identical to imaging from nearly a decade prior.
Key takeaways
Splenosis is the autotransplantation of splenic tissue following traumatic splenic rupture or splenectomy. Ectopic splenic tissue can implant along the diaphragmatic surface or within the hepatic dome, mimicking primary hepatic neoplasms like hepatocellular carcinoma or focal nodular hyperplasia, and should be suspected in any patient with a history of splenectomy and hyper-enhancing abdominal masses.
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