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Intrapancreatic accessory spleen: diagnosis using contrast enhanced ultrasound

Departments of ¹ Radiology and ² Nephrology, Mitsubishi Kyoto Hospital, Katsuragosho-cho, Nishikyo-ku, Kyoto, 6158087 Japan

View larger version (158K): [in a new window]   Figure 1. Arterial phase contrast enhanced CT. Intrapancreatic accessory spleen (IPAS) (arrow) is located in the tail of the pancreas (P). The structure and density of the mass are quite similar to those of the main spleen (S), but this finding is quite similar to that of pancreatic hypervascular tumours. Reprinted by permission of the Society of Nuclear Medicine from: Ota T, et al. Intrapancreatic accessory spleen diagnosed by technetium-99m heat-damaged red blood cell SPECT. J Nucl Med 1997:38;494–5.

View larger version (97K): [in a new window]   Figure 2. Technetium-99m-heat damaged red blood cell SPECT, axial plane. Clear accumulation of radionuclide is seen at the site in question (arrow). A liver uptake is also seen (L), probably due to excessive red blood cell damage. S, proper spleen.

View larger version (119K): [in a new window]   Figure 3. Delayed hepatosplenic phase contrast-enhanced ultrasound (CEUS), left intercostal scan. Grey scale image on the left shows the intrapancreatic accessory spleen (IPAS) (black arrow) which has quite similar echogenicity and internal structure to the main spleen (S). The pancreas (P) shows high echogenicity, likely due to fatty infiltration. Power Doppler image on the right shows clear enhancement of the IPAS (black arrow) as well as the main spleen (S). Blood flow of the splenic vessels is also depicted (white arrows).