Contribution of the single photon emission computed tomography with 99mTc red blood cells in splenosis


  • Luis Muñoz-Bellvis Department of Surgery, Hospital Clinico de Salamanca, Salamanca
  • Jose E. Quiñones-Sampedro Department of Surgery, Hospital Clinico de Salamanca, Salamanca
  • Manuel Iglesias Department of Surgery, Hospital Clinico de Salamanca, Salamanca
  • Oscar Blanco Department of Surgery, Hospital Clinico de Salamanca, Salamanca
  • Luis Miguel González Fernandez Department of Surgery, Hospital Clinico de Salamanca, Salamanca
  • Carmen Esteban Velasco Department of Surgery, Hospital Clinico de Salamanca, Salamanca
  • José María Sayagués Department of Surgery, Hospital Clinico de Salamanca, Salamanca



Splenosis, SPECT-CT, Ultrasound, Spleen, Hepatocellular carcinoma


The term splenosis refers to the presence of auto-transplanted splenic tissue in a heterotopic location. These foci can be localized to the liver simulating a malignant lesion. Sometimes these lesions are difficult to identify using conventional imaging techniques (ultrasound, CT and MR). Then, a scan with denatured erythrocytes marked with 99mTc has proven to be an effective technique to confirm the diagnosis of splenosis and to establish its extension. The incorporation of hybrid imaging techniques (SPECT-CT) into usual clinical practice has increased the precision of the localization of these foci of splenosis. We hereby report the cases of two patients diagnosed with splenosis, the first by laparotomy and the second after performing scintigraphy with red blood cells labeled with 99mTc. In the first case, the laparotomy revealed numerous reticulated nodules on the diaphragmatic peritoneal surface, the transverse colon and the right kidney. Finally, the anatomopathological diagnosis confirmed a case of splenosis. In the second case, the results of the 99mTc marked red blood cell gammagraphy and SPECT-CT were consistent with the diagnosis of splenosis in the patient. To obtain correct information in cases of lesions highly suspicious of splenosis, 99mTc marked red blood cell gammagraphy should be performed due to the high sensitivity and specificity of the test. Combined diagnostic imaging (SPECT-CT), have increased the specificity of this test due to improvements in the characterization of lesions. We believe that the use of this technique will help avoid unnecessary surgical procedures.


Livingston CD, Levine BA, Lecklitner ML, Sirinek KR. Incidence and function of residual splenic tissue following splenectomy for trauma in adults. Arch Surg. 1983;118(5):617-20.

Gunes I, Yilmazlar T, Sarikaya I, Akbunar T, Irgil C. Scintigraphic detection of splenosis: Superiority of tomographic selective spleen scintigraphy. Clin Radiol. 1994;49(2):115-7.

Vuysere DS, Steenbergen VW, Aerts R, Hauwaert VH, Beckevoort VD, Hoe VL. Intrahepatic splenosis: imaging features. Abdom Imaging. 2000;25(2):187-189.

Liu K, Liang Y, Liang X, Yu H, Wang Y, Cai X. Laparoscopic Resection of Isolated Hepatic Splenosis Mimicking Liver Tumors: Case Report With a Literature Review. Surg Laparosc Endosc Percutan Tech. 2012;22(5):e307-11.

Yoshimitsu K, Aibe H, Nobe T. Intrahepatic splenosis mimicking a liver tumor. Abdom Imaging. 1993;18(2):156-8.

Berman AJ , Zahalsky MP, Okon SA, Wagner JR. Distinguishing splenosis from renal masses using ferumoxide enhanced magnetic resonance imaging. Urology. 2003;62(4):748.

Sato N, Abe T, Suzuki N, Waragai M, Teranishi Y, Takano Y, et al. Intrahepatic Splenosis in a chronic hepatitis C patient with no history of splenic trauma mimicking hepatocellular carcinoma. Am J Case Rep. 2014;15:416-20.

Hamrick RA, Bush JD. Autoplastic transplantation of splenic tissue in man following traumatic rupture of the spleen. Ann Surg. 1942;115(1):84-92.

Buchbinder JH, Lipkoff CJ. Splenosis: Multiple peritoneal splenic implants following abdomi- nal injury. A report of a case and review of the literature. Surgery. 1939;6(6):927-34.

Fleming CR, Dickson ER, Harrison EG. Splenosis: autotransplantation of splenic tissue. Am J Med 1976;61(3):414-9.

Davidson LA, Reid IN. Intrahepatic splenic tissue. J Clin Pathol. 1997;50(6):532-3.

Kwok CM, Chen YT, Lin HT, Su CH, Liu YS, Chiu YC. Portal vein entrance of splenic erythrocytic progenitor cells and local hypoxia of liver, two events cause intrahepatic splenosis. Med Hypotheses 2006;67(6):1330-2.

Li T, Yang XY and Tang ZY. Intrahepatic and intraperitoneal splenosis mimicking hepatocellular carcinoma with abdominal wall metastasis in a patient with hepatitis C cirrhotic liver. Surgery 2015;157(5):954-6.

Wu C, Zhang B, Chen L, Zhang B, Chen X. Solitary Perihepatic Splenosis Mimicking Liver Lesion A Case Report and Literature Review. Medicine (Baltimore). 2015;94(9):e586.

Inchingolo R, Peddu P, Karani J. Hepatic splenosis presenting as arterialised liver lesion in a patient with NASH. Eur Rev Med Pharmacol Sci. 2013; 17(21):2853-2856.

Hagan I, Hopkins R, Lyburn I. Superior demonstration of splenosis by heat-denatured Tc-99m red blood cell scintigraphy compared with Tc-99m sulfur colloid scintigraphy. Clin Nucl Med 2006;31(8):463-6.




How to Cite

Muñoz-Bellvis, L., Quiñones-Sampedro, J. E., Iglesias, M., Blanco, O., Fernandez, L. M. G., Velasco, C. E., & Sayagués, J. M. (2017). Contribution of the single photon emission computed tomography with 99mTc red blood cells in splenosis. International Journal of Research in Medical Sciences, 4(6), 2464–2467.



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