Intrathoracic Splenosis after Remote Trauma
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《新英格兰医药杂志》
A healthy 39-year-old man with persistent influenza-like symptoms underwent chest radiography, which showed two pericardial masses (Panels A and B, arrows). Computed tomography (CT) showed that the masses (one 3.3 by 3.3 cm and the other 2.9 by 2.0 cm) were along the lateral pericardium on the left side. Magnetic resonance imaging revealed the masses to be noncystic soft tissue (Panel C). The patient was referred for thoracoscopic resection. The patient had undergone laparotomy 20 years earlier after a motor vehicle accident. He reported that his spleen had been removed, his diaphragm had been repaired, and chest tubes had been placed at that time. Given this history, the blood smear was reviewed and did not demonstrate any Howell–Jolly bodies. The presence of acquired intrathoracic splenosis was confirmed on technetium-99m sulfur colloid scanning. No thoracoscopic procedure was performed, and the patient was told that he was not functionally asplenic and no longer required immediate antimicrobial therapy when he had a fever. His influenza-like symptoms spontaneously resolved. Two years later, CT showed no change in the masses.
Leah M. Backhus, M.D.
Ross M. Bremner, M.D., Ph.D.
University of Southern California
Los Angeles, CA 90033
backhus@usc.edu
Leah M. Backhus, M.D.
Ross M. Bremner, M.D., Ph.D.
University of Southern California
Los Angeles, CA 90033
backhus@usc.edu