Sonographic Appearance of Accessory Spleen

✍ Scribed by Judith F. Katz; Robert A. Kane

• Publisher: John Wiley and Sons
• Year: 1984
• Tongue: English
• Weight: 257 KB
• Volume: 12
• Category: Article
• ISSN: 0091-2751
• DOI: 10.1002/jcu.1870120308

✦ Synopsis

Accessory spleens are common in the normal population; Wadham et al. found accessory spleens in 19% of autopsy patients.' They have been found projecting from the spleen, near the splenic hilum, involved with the pancreas, on the omentum, and in connective tissue. We recently saw a patient with an accessory spleen and were able to suggest the diagnosis on the basis of sonographic findings.

CASE REPORT

A 65-year-old woman was referred for ultrasound examination of the kidneys because of progressive renal failure. She was an obese woman with a long-standing history of diabetes mellitus and recurrent urinary tract infection. She had undergone splenectomy in December 1976 because of hereditary spherocytosis. Ultrasonography demonstrated normal appearing kidneys, but a hypoechoic mass was demonstrated superior to the upper pole of the left kidney (Fig. 1).

The mass was round and measured 6.2 cm in diameter. The differential diagnosis was between accessory spleen and enlarged lymph node; hematoma and abscess were considered unlikely possibilities. Further evaluation with a radioisotope spleen scan was suggested. Using denatured red blood cells labeled with 99mT~, the radionuclide scans demonstrated the mass to be an accessory spleen (Fig. 2).

Review of the clinical record and previous radiographic examinations revealed that the accessory spleen had been a source of confusion on several occasions. It was not seen on the preoperative livedspleen scan in December 1976. Twelve days after splenectomy , a B-mode ultrasound examination for fever and left upper quadrant pain was From the