Pleural thoracic splenosis 17 years after thoracoabdominal blunt trauma

A 35-year-old man presented with progressive left chest pain. He had a history of thoracoabdominal blunt trauma with phrenic rupture that required splenectomy 17 years previously (traffic accident). Magnetic resonance imaging revealed 2 pleural nodules in the left hemithorax, suggestive of neurogenic tumors (Figure 1). On this basis, left video-assisted thoracoscopy surgery was carried out, and 2 red well-defined pleural lesions were identified and removed with hook electrocautery (Figure 2). Pathological examination revealed spleen tissue in both lesions with no signs of malignancy (thoracic splenosis). A nuclear imaging study after surgery (99mTc heat-damaged erythrocytes) revealed no extraabdominal nodules but 3 small nodules were seen in the previous spleen space (Figure 3). OPEN IN VIEWER

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Figure 2.

Video-assisted thoracoscopy surgery view of the pleural splenosis.

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Figure 3.

99mTc heat-damaged erythrocyte gammagraphy revealing 3 abdominal nodules in the previous spleen space (arrows).