CTICasesThoracic Splenosis
Imaging findings
Chest CT shows multiple hyper-enhancing, dense soft-tissue nodules along the left pleural surface. High-resolution non-contrast CT shows these pleural nodules have naturally high attenuation. Abdominal CT demonstrates absence of the spleen and old left-sided rib fractures.
Key takeaways
Thoracic splenosis is the autotransplantation of splenic tissue into the pleural space following traumatic diaphragmatic rupture and splenic injury. The pleural nodules enhance avidly on arterial phase CT and are naturally dense. Recognizing this entity is crucial to avoid misdiagnosing these vascular nodules as pleural metastases or mesothelioma, and diagnosis can be non-invasively confirmed with sulfur colloid or heat-damaged red blood cell scintigraphy.
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