Rola medycyny nuklearnej w diagnostyce różnicowej śledzion dodatkowych u chorych po splenektomii

Abstract

SummaryBackground:More than 10% of healthy population has one or more accessory spleens. The most common location is the hilum of the spleen or area near the tail of the pancreas. The radiological appearance of accessory spleens in oncologic patients who underwent splenectomy can be misinterpreted as a recurrence, especially in the case of compensatory growth of an accessory spleen in successive radiological examinations.Caser Reports:We present the cases of three patients who underwent splenectomy for gastric carcinoid, gastric adenocarcinoma and cancer of the left adrenal gland, respectively. CT examination and/or PET-CT scan revealed suspicious findings in the left upper abdomen. In one patient, the dimensional increase of this finding in successive examinations was initially considered suggestive for cancer recurrence. Scintigraphy with 99mTc-nanocolloid was able to confirm the presence of an accessory spleen in all these patients.Conclusions:Splenic scintigraphy is an economical, accessible and accurate tool in differential diagnosis of accessory spleens in patients after splenectomy.

Diagnosis of gastric subepithelial mass as an accessory spleen using fusion of spleen SPECT and CT images

“…While planar scintigraphy with Tc-99m RBC provides useful information, this 2D imaging technique is inherently limited in ability to provide functional and anatomic correlation. SPECT/CT imaging is very helpful for the anatomic localization of abnormal nuclear scintigraphy findings [10] ; however, the SPECT/CT camera is expensive and is not readily available at all institutions. Fusion of SPECT and CT images using fusion software is an attractive alternative.…”

“…This scan can also be performed with SPECT tomography, allowing evaluation of the radiotracer distribution in 3 dimensions. The SPCET/CT or SPECT and CT fusion images also provide the possibility of differential diagnosis and more precise localization of radiotracer accumulation with regard to anatomical structures [10] .…”

An Intrapancreatic Accessory Spleen That Was Difficult to Diagnose Due to Temporal Changes after Splenectomy

“…In this case, the uptake of 99m Tc by the tumor was detected, and we concluded that the tumor was actually an AS. Some studies have reported the compensated growth of an AS after splenectomy; we therefore considered that the imaging findings of this tumor were caused by hemodynamic changes that occurred due to splenectomy ( 10 , 11 ). However, the reason for the hypovascular change remains unclear.…”

Ectopic splenic tissues mimicking gastro-intestinal stromal tumour in a patient after splenectomy for a giant epithelial cyst of spleen: A case report

“…The splenic hilum situated in the inferior third of the posteromedial compartment and anterolateral to the upper pole of left kidney is the commonest location of an accessory spleen [8] . On retrospective review, 99m Technetium sulfur colloid scintigraphy can be performed to confirm the splenic nature of the lesion [9] .…”