Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Esplenose/diagnóstico , Esplenose/tratamento farmacológico , Esplenose/epidemiologia , Hemorragia Gastrointestinal , Esplenectomia , Melena , Ruptura Esplênica/complicações , Ruptura Esplênica/terapia , Resultado do Tratamento , Pacientes Internados , Exame Físico , Avaliação de Sintomas , Gastroenterologia , GastroenteropatiasRESUMO
Splenosis is defined as the heterotopic autotransplantation of splenic tissue because of a ruptured spleen due to trauma or surgery. It is a benign and incidental finding, although imaging tests may sometimes orient toward malignancy simulating renal tumors, abdominal lymphomas, endometriosis, among other. We report the case of a 42-year old male in whom a MRI was performed after a study due to abdominal pain. Multiple enlarged lymph nodes were observed in the abdomen, suggestive of lymphoproliferative disease. As an important background, splenectomy was carried out due to abdominal trauma at age 9. After several studies, it was decided to perform a (99m)Tc-labeled heat-damaged red blood cell scintigraphy that showed multiple pathological deposits distributed throughout the abdomen, and even the pelvis, being consistent with splenosis.
Assuntos
Esplenose/diagnóstico por imagem , Traumatismos Abdominais/cirurgia , Dor Abdominal/etiologia , Adulto , Bromoexina , Colestase/diagnóstico , Diagnóstico Diferencial , Eritrócitos , Humanos , Achados Incidentais , Metástase Linfática , Transtornos Linfoproliferativos/diagnóstico , Imageamento por Ressonância Magnética , Masculino , Complicações Pós-Operatórias/diagnóstico por imagem , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/patologia , Radiografia , Cintilografia , Compostos Radiofarmacêuticos , Baço/lesões , Baço/cirurgia , Esplenectomia , Esplenose/epidemiologia , Esplenose/etiologia , Esplenose/patologia , Tecnécio , Fatores de TempoRESUMO
Liver transplantation is one of the main therapeutic options for hepatocellular carcinoma (HCC) occurring in cirrhotic patients; an accurate diagnosis and staging of this cancer is crucial to selecting the candidates for this treatment. Although the best diagnostic strategy is debated, the guidelines proposed by the European Association for the Study of the Liver (EASL) are used by many centers. We report 2 cases of cirrhotic patients with hepatic splenosis, a rare condition that may be misinterpreted as HCC. In conclusion, the application of the EASL guidelines in the first case would have led to an incorrect staging of the cancer and in the second case would have led to a false diagnosis of HCC.
