Case 165:   Splenosis (extrahepatic)

Diagnostic Category:

Clinical Presentation:

54 year old tetraplegic man with hepatitis C and history of abdominal trauma sustained in a combat situation many years ago. Incidental hypoechoic liver mass seen on screening ultrasound. AFP was normal.

US: Extrahepatic

Imaging Findings:

Posttraumatic splenosis: ultrasound in sagittal plane demonstrates a hypoechoic mass at the segment 6 with subcapsular appearance. In fact the splenic tissue is extracapsular, but is attached to the liver giving it its subcapsular apprearance.

As opposed to traumatic splenosis, which usually hypoechoic compared even to non-steatotic liver, the rare form of intrahepatic splenosis is usually hyperechoic compared to normal hepatic parenchyma.