16 yo with sickle cell disease
SPR unknown case 2 splenic pseudomass
Publication Date: 2009-02-27
16 year old with sickle cell disease
Splenic involvement in sickle cell disease with vaso-occlusive crisis is common. Often, the spleen becomes infarcted and radiographically will become small and of high density, due to calcification and iron deposition. However, occasionally round “masses” within the infracted spleen have been observed, and have been confused with infection or focal infarction. However, upon surgery and pathological analysis, it was determined that these round “masses” actually represent islands of functional splenic tissue, surrounded by an otherwise diffusely infarcted spleen. These round “masses” have also been proven to represent normal functional splenic tissue on sulfur colloid scanning.
The recognition of these rounded lesions as normal splenic tissue is important, as it can obviate the need for biopsy or splenectomy. The diagnosis can be suggested on ultrasound, CT or MRI. Confirmation of functional splenic tissue can be made with sulfur colloid scanning, if clinically necessary.
- Levin, T.L. “Intrasplenic masses of “preserved” functioning splenic tissue in sickle cell disease: correlation of imaging findings (CT, ultrasound, MRI and nuclear scintigraphy)”, Pediatr Radiol (1996) 26: 646-649.