title: A rare case of hemangiomatosis of the spleen and intrapancreatic accessory spleen.
abstract: We presented a very rare case of hemangiomatosis of the spleen and intrapancreatic accessory spleen in the tail of the pancreas. A previously healthy 45-year-old woman felt left back pain and received CT scan. Multiple splenic masses and a pancreatic mass in the tail were detected. Both the lesions presented gradual and weak enhancement and pooling of the contrast medium until very late phase on dynamic MRI. Since the lesions in the spleen and the pancreas presented the same characteristics on dynamic CT/MRI, ultrasonography, and positron emission tomography using fluorine-18-fluorodeoxyglucose, we suspected these lesions as hemangiomatosis of the spleen and intrapancreatic accessory spleen. We performed distal pancreatectomy with splenectomy, and pathological diagnosis was hemangiomatosis of the spleen and intrapancreatic accessory spleen. We should consider the possibility of splenic tumors arising from the spleen and intrapancreatic accessory spleen when we find similar lesions in the spleen and the tail of the pancreas. Gradual and weak enhancement and pooling of the contrast medium until very late phase may be important findings for diagnosing splenic hemangiomatosis.
authors.affiliation: Department of Gastroenterologic Surgery, Graduate School of Medical Science, Kanazawa University Hospital, Kanazawa University, 13-1 Takaramachi, Kanazawa, Ishikawa, 920-8641, Japan, i.makino@staff.kanazawa-u.ac.jp.
authors.forename: Isamu
authors.initials: I
authors.lastname: Makino
authors.forename: Hidehiro
authors.initials: H
authors.lastname: Tajima
authors.forename: Hirohisa
authors.initials: H
authors.lastname: Kitagawa
authors.forename: Hisatoshi
authors.initials: H
authors.lastname: Nakagawara
authors.forename: Tetsuo
authors.initials: T
authors.lastname: Ohta
mesh_terms: D003287:Contrast Media; D003937:Diagnosis, Differential; D005260:Female; D019788:Fluorodeoxyglucose F18; D019786:Gadolinium DTPA; D006391:Hemangioma / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008875:Middle Aged; D010179:Pancreas / Q000601:surgery; D010180:Pancreatectomy / Q000379:methods; D049268:Positron-Emission Tomography / Q000379:methods; D019275:Radiopharmaceuticals; D013154:Spleen / Q000002:abnormalities* / Q000473:pathology / Q000601:surgery; D013156:Splenectomy / Q000379:methods; D013160:Splenic Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D014057:Tomography, X-Ray Computed / Q000379:methods
chemical_list: D003287:Contrast Media; D019275:Radiopharmaceuticals; C073590:gadolinium ethoxybenzyl DTPA; D019788:Fluorodeoxyglucose F18; D019786:Gadolinium DTPA