Congenital cyst in female accessory spleen: a case report

Cysts found in splenic stores, of parasitic or non-parasitic origin, are rare causes of recurrent abdominal pain, but with a significant increase in the number of diagnoses in recent years. This condition is caused by the derivation of the mesothelial cell lining of the spleen capsule, occurring in 0.5 - 2% of the world population. Clinically, patients tend to remain asymptomatic for years and usually have an incidental diagnosis by imaging exams or during the investigation of diffuse and recurrent abdominal pain, rarely found in females. The treatment of splenic cysts is performed through video laparoscopic splenic resection.

A Case of İntrapancreatic Accessory Spleen Mimicking a Pancreatic Metastasis on the 18F-FDG PET/CT Scan: A Case with Breast Cancer

The accessory spleen is a focus of splenic tissue which is separated from the main of the spleen. Although accessory spleens are generally recognized on computed tomography (CT), intrapancreatic accessory spleen (IPAS) may be mistaken for other pancreatic tail lesions. We report a case of IPAS mimicking a pancreatic metastasis on the 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT). A 41-year-old with diagnosed breast cancer (invasive ductal carcinoma) woman patient underwent an 18F-FDG PET/CT for metastasis screening and staging. 18F-FDG PET/CT showed a focal uptake in the pancreatic tail. The patient underwent a contrast-enhanced CT and magnetic resonance imaging (MRI) for lesion characterization. The density and intensity of lesion were similar to spleen on all phases and all sequences. The lesion was evaluated as IPAS. The diagnosis was confirmed by endoscopic ultrasound (EUS) biopsy. A case of IPAS positive at 18F-FDG PET/CT could not found in the literature. We present a case of IPAS mimicking a pancreatic metastasis positive at 18F-FDG PET/CT.

A Cadaveric Study on Morphometric Features of Spleen and Splenomegaly with Accessory Spleen in Hilum

Background: Anatomical knowledge regarding the external morphology of the spleen is essential for surgical intervention and radiological diagnosis. Splenomegaly is defined as pathologic enlargement of the spleen measured by size or weight. A normal spleen has a craniocaudal length of no more than 12 cm and weighs less than 200 g. It is surrounded by a thin capsule. The spleen is usually not palpable unless it is enlarged; therefore, a palpable spleen is almost always abnormal. At times the spleen may be difficult to palpate, but dullness to percussion during inspiration in the area of the lower left intercostal space in the left anterior axillary line suggests splenic enlargement. Massive splenomegaly, weight >1000 g usually occurs in lymphoma, myeloproliferative disorders, visceral leishmaniasis, and malaria. Materials and Methods: This study was conducted in different medical institutions, to find morphometric features, spenomegaly in cadaver during routine anatomy dissection as part of curriculum, 100 cadavers were observed to find out splenomegaly. Results: Out of 100 spleens studied, 81 cases wedge shaped spleen was the most common, followed by 12 tetrahedral shaped spleens and 7 oval shaped spleens. Average weight of the spleen was 175g. Average length of the spleen was 11.64cm, Average breadth of the spleen was 7.3cm and average thickness of spleen was 3.6cm. Out of 100 cadavers observed only one cadaver observed with massive splenomegaly with one accessory spleen in hilum. The spleen weight was 875gm, length was 18.15 cm, width was 8.65cm, thickness was 5.75cm and extended upto 7 rib and it is easily palpable below the rib cage from lumbar aspect. The cadaver was male and age around 55 years. Conclusion: The morphometric knowledge of spleen will helpful for surgeons and for understanding deceases related spleen. The knowledge of splenomegaly is important in finding splenic disorders and accessory spleen information helpful in understanding embryonic development of spleen. KEY WORDS: Splenomegaly, Spleen, Hilum of Spleen, Accessory spleen.