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Logo of bmjcrInstructions for authorsCurrent ToCBMJ Case Reports
 
BMJ Case Rep. 2010; 2010: bcr0320102833.
Published online 2010 September 10. doi:  10.1136/bcr.03.2010.2833
PMCID: PMC3028306
Reminder of important clinical lesson
The (re)generation of splenic tissue
J W R Hovius,1,2 H J Verberne,3 R J Bennink,3 and W L Blok1
1Department of Internal Medicine, Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands
2Department of Internal Medicine, Academic Medical Center, Amsterdam, The Netherlands
3Department of Nuclear Medicine, Academic Medical Center, Amsterdam, The Netherlands
Correspondence to J W R Hovius, j.w.hovius/at/amc.uva.nl
Abstract
A 48-year-old man with a history of a traumatic splenic rupture followed by splenectomy at the age of 5 years was referred to the outpatient clinic with markedly elevated liver enzymes. He was diagnosed with alcoholic liver cirrhosis. Ultrasound of the upper abdomen revealed hepatomegaly and suggested a central mass in the liver. Subsequent MRI of the abdomen did not show a hepatic mass, but revealed multiple intraperitoneal and retroperitoneal ovoid structures with a maximum diameter of 3 cm. A peripheral blood smear did not reveal Howell-Jolly bodies suggesting intact splenic function. The diagnosis splenosis—that is, autotransplantation of splenic tissue after iatrogenic/traumatic rupture of the spleen—was considered and confirmed by SPECT-CT with technetium-99m (99mTc) labelled heat-denatured autologous red blood cells.
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