Noninvasive Identification of Splenosis Through Tc-99m Scintigraphy

Background

Splenosis, the presence of ectopic splenic tissue, can occur after splenectomy and may mimic other abdominal masses, complicating diagnosis. Accurate identification is crucial to prevent unnecessary invasive procedures, as noted in the literature. Noninvasive imaging techniques like Tc-99m scintigraphy offer a safer alternative for diagnosis in patients with a history of splenectomy.

Data Highlights

• The case involved a patient with hereditary spherocytosis who had undergone splenectomy five years earlier.

• Tc-99m-labeled heat-damaged red blood cell scintigraphy, with SPECT/CT, showed intense tracer uptake in multiple peritoneal nodules, confirming splenosis.

• Blood tests showed reticulocytosis and thrombocytosis; Howell–Jolly bodies and thrombocytosis did not rule out splenosis.

Key Findings

• The patient had a history of hereditary spherocytosis and splenectomy five years prior.

• Blood tests showed post-splenectomy changes, including reticulocytosis and thrombocytosis.

• Selective splenic scintigraphy with Tc-99m-labeled heat-damaged red blood cells confirmed splenosis.

• SPECT/CT revealed intense tracer accumulation in multiple peritoneal nodules.

• Detection of Howell–Jolly bodies and thrombocytosis does not exclude splenosis.

Clinical Implications

Tc-99m scintigraphy with heat-damaged red blood cells is a reliable noninvasive method for diagnosing splenosis, particularly in patients with prior splenectomy.

Conclusion

The use of Tc-99m scintigraphy provides a means of diagnosing splenosis, confirming the presence of ectopic splenic tissue without invasive procedures.

Related Resources & Content

1. Journal of Gastrointestinal Surgery, 2014 -- Abdominopelvic Splenosis: An Uncommon Etiology of Tenesmus

2. European Radiology, 2025 -- Assessment of Liver Function Through Multiphase Hepatic CT: Evaluating the Diagnostic Efficacy of Iodine Uptake and Volumetric Metrics

3. European Radiology, 2024 -- Loss of T2 Signal Intensity in the Spleen on MRI Correlates with Disease Severity in Multiple Myeloma

4. EJNMMI Reports, 2026 -- Thoracic splenosis: a great mimic diagnosed by functional imaging

5. MDSpire News — Early Research Shows Novel PET/CT Tracer May Aid in Early Detection of Rheumatoid Arthritis

6. Thoracic splenosis: a great mimic diagnosed by functional imaging

7. A rare right hemithorax splenosis: Case of thoracic and abdominal splenosis - PMC

8. Adult Immunization Schedule Notes | Vaccines & Immunizations | CDC