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Detection of splenosis on somatostatin receptor scintigraphy – a case report


Authors: Iva Štufková 1;  Lukáš Fil 1;  Otto Lang 1,2
Authors‘ workplace: Oddělení nukleární medicíny, Oblastní nemocnice Příbram, a. s., Příbram, ČR 1;  Klinika nukleární medicíny, 3. LF UK a FNKV, Praha 10, ČR 2
Published in: NuklMed 2017;6:70-73
Category: Casuistry

Overview

Aim:
Presentation of an atypical pattern on somatostatin receptor scintigraphy with a risk of false positive interpretation.

Case report:
42y-old patient was sent to our department for somatostatin receptor scintigraphy due to a suspicion to neuroendocrine tumor. He experienced a long lasting chronic diarrhea with abdominal pain. He underwent several abdominal surgeries, he had an accident with the liver and spleen laceration with a following splenectomy 13 years ago. Irregularly increased accumulation of a radiopharmaceutical (111In-pentetreotide) in the left mesogastrium anteriorly except of physiological accumulation in the liver and kidneys was detected on somatostatin receptor scintigraphy. Small nodules were visible on SPECT/CT images at this location. This patient was evaluated in our department with denaturated erythrocytes due to multiple nodules detected on CT image in the left mesogastrium two months ago; splenic tissue was confirmed in these nodules. Comparing these images with somatostatin receptor scintigraphy, we concluded that atypical location of somatostatin receptors at the left mesogastrium is caused by accumulation of radiopharmaceutical in the splenic tissue in patient after splenectomy with autotransplantation.

Conclusion:
We present a case of a detection of a splenosis on somatostatin receptor scintigraphy performed in patient evaluated for a suspicion of neuroendocrine tumor. Our case report alerts to a risk of false positive interpretation and points out the necessity of a careful history including a record of splenosis into the medical documentation in a patient with a splenic injury in the past. This can spare such patient unnecessary and potentially risk future invasive examination.

Key words:
splenectomy, splenosis, denaturated erythrocytes scintigraphy, somatostatin receptor scintigraphy, 111In-pentetreotide


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