Splenic imaging in a patient with functional asplenia.
A 65-year-old woman presented with right upper extremity paralysis and left cerebrovascular accident. A routine complete blood count (CBC) demonstrated Howell-Jolly bodies on peripheral smear, and a liver-spleen scan showed absent splenic sulfur colloid uptake suggesting functional asplenia. A subsequent heat damaged red blood cell study demonstrated a normal sized spleen with preserved sequestering function, thereby excluding anatomic asplenia, vascular alterations, or congenital anomalies in the differential diagnosis of functional asplenia. This case illustrates the use of Tc-99m heat damaged red blood cells as a unique and useful diagnostic aid in identifying the presence and size of a spleen in patients with functional asplenia. It also demonstrates an apparent qualitative separation of splenic functions in processing sulfur colloid and heat damaged red blood cells.
Wagman
P G
PG
Department of Nuclear Medicine, William Beaumont Hospital, Royal Oak, MI 48072.
Dworkin
H J
HJ
D000368:Aged; D004908:Erythrocyte Inclusions; D004912:Erythrocytes; D005260:Female; D006358:Hot Temperature; D006801:Humans; D012157:Mononuclear Phagocyte System / Q000503:physiopathology; D011877:Radionuclide Imaging; D013154:Spleen / Q000000981:diagnostic imaging* / Q000503:physiopathology; D013667:Technetium; D013671:Technetium Tc 99m Sulfur Colloid
D013671:Technetium Tc 99m Sulfur Colloid; D013667:Technetium