A case of intrahepatic splenosis after splenic rupture with difficulty in preoperative diagnosis

Abstract

The patient was 47 year-old man who underwent splenectomy for splenic rapture by traffic accident at the age of 16. He was admitted to our hospital and took an abdominal ultrasonography. It showed a hypoechoic tumor, 20 mm in diameter, originated from the liver in lateral segment, and hypervascular legion was detected by contrast computed tomography (CT) image and magnetic resonance imaging (MRI). Angiography showed tumor stain fed by the branch of hepatic artery (A2). CT in combined positron emission tomography (PET-CT) showed no increase of fluorodeoxy glucose (FDG) uptake in the area corresponding to the mass. Although malignant lymphoma was suspected of by liver biopsy, histopathological examination confirmed intrahepatic splenosis after hepatectomy. It seemed to be very difficult to diagnose intrahepatic splenosis, whereas it is suggested that vascular and Kupffer imaging with Sonazoid enhanced ultrasound was useful for the diagnosis.