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Findings: Serial axial CT images of the abdomen demonstrate a rounded, homogeneous soft-tissue mass measuring 1 cm in transverse width, located just caudal and slightly anterior to the inferior margin of the spleen.
Diagnosis:Accessory Spleen
Discussion: Accessory spleens, or splenculi, are relatively commonly encountered "normal" anatomic variants, estimated to be present in approximately 10% of the population.(2) They may be single or multiple in occurrence, and are most frequently discovered in the vicinity of the splenic hilum or elsewhere within the gastrosplenic ligament. They may, however, be found along the omentum, or anywhere else within the peritoneal cavity. (4)
CT scanning reveals the accessory spleen(s) to be of attenuation and contrast-enhancement characteristics that are identical to those of normal spleen.(3) They usually measure approximately 1.0 - 1.5 cm in diameter, but may range in size from a few millimeters to several centimeters.(2,3)
Resection of all accessory spleens is recommended at the time of splenectomy, as cases of accessory-splenic hypertrophy have been described subsequent to removal of the "main" spleen.(1)
References:
1. Beahrs, JR and Stephens DH. Enlarged accessory spleens:
CT appearance in postsplenectomy patients. AJR 135:483-486, 1980.
2. Dodds WJ, Taylor AJ, Erickson SJ, Stewart ET and Lawson TL.
Radiologic imaging of splenic abnormalities. AJR 155:805-810, 1990.
3. Grumbach K and McDowell RK. The Spleen. In: Computed Tomography
and Magnetic Resonance Imaging of the Whole Body, 3rd edition, pages 1131-1150.
Haaga JR, Lanzieri CF, Sartoris DJ, and Zerhouni:, eds. Mosby, 1994.
4. Stiris MG. Accessory spleen versus left adrenal tumor:
Computed tomographic and abdominal angiographic evaluation.
J Comput Assist Tomogr 4:543-544, 1980.
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