CTICasesPleural Splenosis
Imaging findings
Chest CT showed a complex left pleural collection with loculations and high-attenuation nodules. Abdominal CT revealed multiple high-attenuation soft tissue masses in the upper abdomen consistent with splenules, which enhanced homogeneously on portal venous phase imaging — with enhancement and density identical to the pleural implants.
Key takeaways
Pleural splenosis typically results from prior splenic trauma or rupture, allowing splenic tissue to seed the pleura. Recognizing these masses is critical to avoid misdiagnosing them as occult malignancy. While history and characteristic imaging are often sufficient, nuclear medicine studies (e.g., sulfur colloid or damaged red blood cell scans) can confirm the diagnosis when needed. Residual splenic tissue can also cause complications such as hypersplenism even after splenectomy.
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