Intrapancreatic accessory spleen as a rare solid pancreatic lesion

Česká verzia

Authors: Krlínová I. ¹; Shon F. ¹; Štiková Z. ²; Maxa V. ³; Mareš L. ⁴; Šabata L. ³
Authors place of work: Gastroenterologické oddělení, Nemocnice České Budějovice, a. s. ¹; Patologické oddělení, Nemocnice České Budějovice, a. s. ²; Oddělení nukleární medicíny, Nemocnice České Budějovice, a. s. ³; Radiologické oddělení, Nemocnice České Budějovice, a. s. ⁴
Published in the journal: Gastroent Hepatol 2018; 72(6): 522-526
Category:
doi: https://doi.org/10.14735/amgh2018522

Summary

The incidence of solid pancreatic lesions (SPL) is currently increasing as a result of the increasing number of imaging examinations. It is often an incidental finding. A special case of SPL is an intrapancreatic accessory spleen (IPAS). We present a rare IPAS finding in two case reports. The first case is a 62-year-old man with diagnosed early cancer of the ascending colon, in whom primary IPAS diagnosis was based on a postoperative histopathological examination. The second case is a 50-year-old woman with a renal cyst, in whom IPAS diagnosis was based on the imaging findings obtained using Technetium-99m scintigraphy (Tc-99m SPECT). Because IPAS is a benign lesion of the pancreas, diagnosis using functional imaging of splenic tissue (Tc-99m Heat-damaged Red Blood Cell scintigraphy, contrast-enhanced ultrasonography using microgranules and superparamagnetic iron oxide (SPIO)-enhanced magnetic resonance imaging), as well as other diagnostic modalities, is the preferred option. Another method of diagnosis is endoscopic ultrasound guided fine needle aspiration. However, the diagnosis of this lesion is still difficult. A significant number of SPLs are potentially malignant; therefore, most cases are indicated for surgical resection, in which case IPAS diagnosis is based on postoperative histopathological examination.

Key words:

intrapancreatic accessory spleen – differential diagnosis – pancreatic neoplasms

Submitted: 23. 4. 2018

Accepted: 12. 5. 2018

The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study.

The Editorial Board declares that the manuscript met the ICMJE „uniform requirements“ for biomedical papers.

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