Splenic Resection or Heterotopic Transplantation of Splenic Tissue as Alternatives to Splenectomy

Abstract Objectives Ferumoxytol is an ultra-small superparamagnetic iron oxide (USPIO) agent that is taken up by splenic tissue. This study describes our initial institutional experience of ferumoxytol-enhanced MRI (feMRI) for differentiating intrapancreatic splenules (IPS) from other pancreatic lesions. Methods In this retrospective study, patients with computed tomographic imaging that identified small enhancing lesions in the tail of the pancreas subsequently underwent feMRI for further characterization. The feMRI protocol included T2-weighted (T2w) imaging with and without fat suppression (FS), R2* mapping, diffusion-weighted imaging (DWI), and T1-weighted (T1w) imaging with FS, prior to contrast injection. Immediately after slow intravenous infusion with 3 mg/kg body weight ferumoxytol, T1w was repeated. Delayed imaging with all sequences were obtained 24–72 h after ferumoxytol administration. Results Seven patients underwent feMRI. In two patients, the pancreatic lesions were presumed as pancreatic neuroendocrine tumor (PNET) from feMRI and in the remaining 5 IPS. One of the two patients with PNET was symptomatic for NET. In another symptomatic patient with pathologically proven duodenal NET and suspected PNET, the pancreatic lesion was proven to be an IPS on feMRI. IPS demonstrated strong negative enhancement in feMRI on T2w and increased R2* values consistent with splenic tissue, while the presumed PNETs did not enhance. T2w FS was helpful on the pre-contrast images to identify IPS, while R2* did on post-contrast images. Neither DWI nor T1w contributed to differentiating PNETs from IPS. Conclusions This study demonstrates the potential utility of feMRI as a helpful adjunct diagnostic tool for differentiating IPS from other pancreatic lesions. Further studies in larger patient cohorts are needed.

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Coincidence of Intra-Abdominal Splenosis in a Patient with Advanced Ovarian Cancer: Case Report and Review of the Literature

The Surgery Journal ◽

10.1055/s-0041-1731426 ◽

2021 ◽

Vol 07 (02) ◽

pp. e116-e120

Author(s):

Tatjana Braun ◽

Amelie De Gregorio ◽

Lisa Baumann ◽

Jochen Steinacker ◽

Wolfgang Janni ◽

...

Keyword(s):

Ovarian Cancer ◽

Case Report ◽

Diagnostic Imaging ◽

Medical History ◽

Rare Disease ◽

Metastatic Cancer ◽

Abdominal Cavity ◽

Advanced Ovarian Cancer ◽

Splenic Tissue ◽

Tumor Spread

AbstractSplenosis is a rare disease, which is often discovered incidentally years after surgical procedures on the spleen or traumatic splenic lesions. Through injury of the splenic capsule, splenic cells are able to spread and autoimplant in a fashion similar to the process of metastatic cancer. Here we present the case of a 62-year-old female patient with a palpable tumor of the lower abdomen. Her medical history was unremarkable, except for splenectomy after traumatic splenic lesion in her childhood. Clinical examination and diagnostic imaging raised the suspicion of advanced ovarian cancer, which was further substantiated by the typical presentation of adnexal masses and disseminated peritoneal metastases during the following staging laparotomy. Surprisingly, we also found peritoneal implants macroscopically similar to splenic tissue. Microscopic examination of tissue specimens by intrasurgical frozen section confirmed the diagnosis of intra-abdominal splenosis. The patient then underwent cytoreductive surgery with complete resection of all cancer manifestations, sparing the remaining foci of splenosis to avoid further morbidity. This case demonstrates the rare coincidence of intra-abdominal carcinoma and splenosis, which could lead to intraoperative difficulties by misinterpreting benign splenic tissue. Therefore, splenosis should be considered in patients with medical history of splenic lesions and further diagnostic imaging like Tc-99m-tagged heat-damaged RBC scan could be used for presurgical distinguishing between tumor spread in the abdominal cavity and disseminated splenosis. The presented case report should not only raise awareness for the rare disease splenosis, but also emphasize the need to consider the possibility of simultaneous incidence of benign and malignant intra-abdominal lesions, as to our knowledge this is the first published case of simultaneous peritoneal carcinomatosis and splenosis.

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ACELLULAR LIVER SCAFFOLD PROMOTES CELL RECRUITMENT AFTER HETEROTOPIC TRANSPLANTATION

Cytotherapy ◽

10.1016/j.jcyt.2021.02.010 ◽

2021 ◽

Vol 23 (4) ◽

pp. 1-2

Author(s):

ML Dias ◽

CMP Batista ◽

R Martins-Santos ◽

AC Silva ◽

CBV Andrade ◽

...

Keyword(s):

Heterotopic Transplantation ◽

Cell Recruitment

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Bioengineered Livers: A New Tool for Drug Testing and a Promising Solution to Meet the Growing Demand for Donor Organs

European Surgical Research ◽

10.1159/000446211 ◽

2016 ◽

Vol 57 (3-4) ◽

pp. 224-239 ◽

Cited By ~ 9

Author(s):

Franziska Mußbach ◽

Utz Settmacher ◽

Olaf Dirsch ◽

Chichi Xie ◽

Uta Dahmen

Keyword(s):

Drug Testing ◽

Vascular System ◽

Observation Time ◽

Heterotopic Transplantation ◽

Physiological Models ◽

Innovative Strategy ◽

Pharmacological Research ◽

Organ Specific ◽

Static Conditions ◽

Donor Organs

Background: Organ engineering is a new innovative strategy to cope with two problems: the need for physiological models for pharmacological research and donor organs for transplantation. A functional scaffold is generated from explanted organs by removing all cells (decellularization) by perfusing the organ with ionic or nonionic detergents via the vascular system. Subsequently the acellular scaffold is reseeded with organ-specific cells (repopulation) to generate a functional organ. Summary: This review gives an overview of the state of the art describing the decellularization process, the subsequent quality assessment, the repopulation techniques and the functional assessment. It emphasizes the use of scaffolds as matrix for culturing human liver cells for drug testing. Further, it highlights the techniques for transplanting these engineered scaffolds in allogeneic or xenogeneic animals in order to test their biocompatibility and use as organ grafts. Key Messages: The first issue is the so-called decellularization, which is best explored and resulted in a multitude of different protocols. The most promising approach seems to be the combination of pulsatile perfusion of the liver with Triton X-100 and SDS via hepatic artery and portal vein. Widely accepted parameters of quality control include the quantitative assessment of the DNA content and the visualization of eventually remaining nuclei confirmed by HE staining. Investigations regarding the composition of the extracellular matrix focused on histological determination of laminin, collagen, fibronectin and elastin and remained qualitatively. Repopulation is the second issue which is addressed. Selection of the most suitable cell type is a highly controversial topic. Currently, the highest potential is seen for progenitor and stem cells. Cells are infused into the scaffold and cultured under static conditions or in a bioreactor allowing dynamic perfusion of the scaffold. The quality of repopulation is mainly assessed by routine histology and basic functional assays. These promising results prompted to consider the use of a liver scaffold repopulated with human cells for pharmacological research. Transplantation of the (repopulated) scaffold is the third topic which is not yet widely addressed. Few studies report the heterotopic transplantation of repopulated liver tissue without vascular anastomosis. Even fewer studies deal with the heterotopic transplantation of a scaffold or a repopulated liver lobe. However, observation time was still limited to hours, and long-term graft survival has not been reported yet. These exciting results emphasize the potential of this new and promising strategy to create physiological models for pharmacological research and to generate liver grafts for the transplant community to treat organ failure. However, the scientific need for further development in the field of liver engineering is still tremendous.

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Heterotopic transplantation of presumptive placodal ectoderm changes the fate of sensory neuron precursors

Development ◽

10.1242/dev.119.1.263 ◽

1993 ◽

Vol 119 (1) ◽

pp. 263-276 ◽

Cited By ~ 10

Author(s):

K.S. Vogel ◽

A.M. Davies

Keyword(s):

Growth Rate ◽

Sensory Neurons ◽

Chicken Embryo ◽

Neurite Growth ◽

Heterotopic Transplantation ◽

Growth And Survival ◽

Avian Embryos ◽

Nodose Ganglia ◽

Innervation Patterns

The placode-derived cranial sensory neurons of the vestibular and nodose ganglia in avian embryos exhibit differences in neurite growth rate and the duration of neurotrophin-independent survival in vitro that arise prior to gangliogenesis and target contact (Davies, A. M. (1989) Nature 337, 553–555; Vogel, K. S. and Davies, A. M. (1991) Neuron 7, 819–830). To ascertain the state of commitment of presumptive placodal ectoderm to differentiate into neurons of the vestibular or nodose type, we performed heterotopic transplantation of labelled presumptive placodal ectoderm at E1.5 in the chicken embryo. We then assayed transplant-derived neurons for hindbrain innervation patterns, neurite growth and survival at E3.5. We show that presumptive placodal ectoderm is not determined to give rise to neurons of the vestibular or nodose phenotype at E1.5. Explantation of presumptive placodal ectoderm at E1.5 showed that this ectoderm is also not specified to differentiate into neurons at this stage. In addition, we demonstrate that non-neurogenic ectoderm from the trunk can give rise to nodose-type neurons when transplanted heterotopically to the nodose region.

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INTRAOPERATIVE HEMODYNAMICS IN LIVER TRANSPLANTATION COMPARING ORTHOTOPIC WITH HETEROTOPIC TRANSPLANTATION IN THE PIG

Transplantation Journal ◽

10.1097/00007890-199004000-00001 ◽

1990 ◽

Vol 49 (4) ◽

pp. 665-668 ◽

Cited By ~ 5

Author(s):

JAN D. BLANKENSTEIJN ◽

THEO H. N. GROENLAND ◽

DIETER BAUMGARTNER ◽

LAMMERT P. VOS ◽

LEON G. M. KERKHOFS ◽

...

Keyword(s):

Liver Transplantation ◽

Heterotopic Transplantation

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Histopathological and Hematological Changes in Mummichogs, Fundulus heteroclitus, Infected by a Pseudomonad

Journal of the Fisheries Research Board of Canada ◽

10.1139/f78-217 ◽

1978 ◽

Vol 35 (10) ◽

pp. 1376-1381 ◽

Cited By ~ 1

Author(s):

M. F. Li ◽

G. S. Traxler ◽

S. Clyburne

Keyword(s):

Fundulus Heteroclitus ◽

Renal Tissue ◽

Infected Fish ◽

Splenic Tissue ◽

Hepatic Veins ◽

Renal Tubules ◽

Fish Disease ◽

Histopathological Changes ◽

Key Words Fish ◽

Hematological Changes

The hematological and histopathological changes in mummichogs infected by Pseudomonas reptilivora included a dramatic reduction in hematocrit values; massive structural lymphoid necrosis with formation of edematous spaces in the splenic tissue; empty and degenerate hepatic veins and sinusoids; and necrosis of the renal tubules in naturally and experimentally infected fish. Electron microscopy of the renal tissue revealed clumps of chromatin in the nuclei, disintegration or degeneration of organelles, and an increase of digestive vesicles or autophagic vacuoles in the cells. This is the first description of the pathology of this bacteria in a marine fish. Key words: fish disease, Pseudomonas, bacteria, hemorrhagic septicemia

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pH environmental of red cells in the spleen

American Journal of Physiology-Legacy Content ◽

10.1152/ajplegacy.1976.231.6.1672 ◽

1976 ◽

Vol 231 (6) ◽

pp. 1672-1678 ◽

Cited By ~ 17

Author(s):

MJ Levesque ◽

AC Groom

Keyword(s):

Splenic Tissue ◽

Red Cells ◽

Red Cell ◽

Cat Spleen ◽

Flow Through ◽

Red Pulp ◽

Reduced Flow

Intrasplenic pH in vivo was deduced from measurements on blood drained from cat spleen during contraction with the inflow occluded. The pH of blood in the red pulp is normally 7.20, but stasis or reduced flow through the pulp causes pH to fall toward 6.8. The splenic pulp contains blood of high hematocrit. To evaluate the role of buffering by the red cells themselves, intrasplenic p/ in red cell-free spleens was, therefore, estimated atering and leaving the spleen during red cell washout. At inflow pH less than 6.8 the outflow pH was raised, at inflow pH = 6.8 there was no change, b,t at inflow pH greater than 6.8 the outflow pH was lowered. These results indicate that the pH environment of red cells in the spleen results indicate that the pH environment of red cells in the spleen results from the interplay of two separate factors: i) pH-determining elements of the splenic tissue that buffer at 6.8, and ii) buffering provided by red cells passing through the pulp.

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Autotransplantation of splenic tissue

Journal of Pediatric Surgery ◽

10.1016/s0022-3468(86)80062-8 ◽

1986 ◽

Vol 21 (2) ◽

pp. 120-124 ◽

Cited By ~ 28

Author(s):

Reinhard Pabst ◽

Daryouch Kamran

Keyword(s):

Splenic Tissue

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