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a hepatologie

Gastroenterology and Hepatology

Gastroent Hepatol 2018; 72(6): 522–526. doi:10.14735/amgh2018522.

Intrapancreatic accessory spleen as a rare solid pancreatic lesion

Ivana Krlínová1, Filip Shon1, Zuzana Štiková2, Václav Maxa3, Lukáš Mareš4, Ladislav Šabata3

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The incidence of solid pancreatic lesions (SPL) is currently increasing as a result of the increasing number of imaging examinations. It is often an incidental finding. A special case of SPL is an intrapancreatic accessory spleen (IPAS). We present a rare IPAS finding in two case reports. The first case is a 62-year-old man with diagnosed early cancer of the ascending colon, in whom primary IPAS diagnosis was based on a postoperative histopathological examination. The second case is a 50-year-old woman with a renal cyst, in whom IPAS diagnosis was based on the imaging findings obtained using Technetium-99m scintigraphy (Tc-99m SPECT). Because IPAS is a benign lesion of the pancreas, diagnosis using functional imaging of splenic tissue (Tc-99m Heat-damaged Red Blood Cell scintigraphy, contrast-enhanced ultrasonography using microgranules and superparamagnetic iron oxide (SPIO) -enhanced magnetic resonance imaging), as well as other diagnostic modalities, is the preferred option. Another method of diagnosis is endoscopic ultrasound guided fine needle aspiration. However, the diagnosis of this lesion is still difficult. A significant number of SPLs are potentially malignant; therefore, most cases are indicated for surgical resection, in which case IPAS diagnosis is based on postoperative histopathological examination.


differential diagnosis, intrapancreatic accessory spleen, pancreatic neoplasms

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