To describe the use of Tc-99m scintigraphy with heat-damaged red blood cells in evaluating suspected splenosis.
Approach:
Patient Case: A 23-year-old woman with hereditary spherocytosis and a history of splenectomy presented with abdominal masses.
Diagnostic Imaging: Pelvic MRI and CT showed masses, with splenosis and lymphoma considered in the differential diagnosis.
Scintigraphy Procedure: Tc-99m-labeled heat-damaged red blood cell scintigraphy with SPECT/CT was performed to assess for functioning splenic tissue.
Key Findings:
SPECT/CT showed intense tracer uptake in multiple peritoneal nodules, supporting the diagnosis of splenosis.
Howell–Jolly bodies and thrombocytosis were present; these findings did not rule out splenosis in this case.
Interpretation:
Tc-99m-labeled heat-damaged red blood cell scintigraphy with SPECT/CT can help identify functioning splenic tissue and support a noninvasive diagnosis of splenosis.
Limitations:
This report describes a single patient and does not establish diagnostic performance or generalizability.
The findings should be interpreted in the context of the clinical presentation and other imaging.
Conclusion:
In this case, Tc-99m scintigraphy with heat-damaged red blood cells supported the diagnosis of splenosis and may help avoid biopsy when findings are diagnostic.
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