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Imaging of an Accessory Spleen Presenting as a Slow-Growing Mass in the Transplanted Pancreas

Kousei Ishigami1, Bradley Hammett1, Masao Obuchi1, Daniel Katz2, Stephen Rayhill2, Ahmed Fathala1 and Monzer Abu-Yousef1

1 Department of Radiology, University of Iowa Carver College of Medicine, 200 Hawkins Dr., 3885 JPP, Iowa City, IA 52242-1077.
2 Department of Surgery, University of Iowa Carver College of Medicine, Iowa City, IA 52242-1077.



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  		Fig. 1A. —45-year-old woman with accessory spleen in transplanted pancreas. Unenhanced CT scan obtained 4 years earlier shows soft-tissue-density nodule (arrow) in tail of transplanted pancreas.

 


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  		Fig. 1B. —45-year-old woman with accessory spleen in transplanted pancreas. Axial T2-weighted fast spin-echo image with fat saturation shows high-intensity round mass, which shows apparent interval increase in size. Signal intensity of mass appears similar to that of spleen. Note flow void in mass.

 


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  		Fig. 1C. —45-year-old woman with accessory spleen in transplanted pancreas. Gadolinium-enhanced coronal T1-weighted fast spoiled gradient-echo image with fat saturation reveals mass to be of relatively low intensity compared with pancreatic graft. Note beak sign, which suggests that mass arises from tail of transplanted pancreas.

 


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  		Fig. 1D. —45-year-old woman with accessory spleen in transplanted pancreas. Color Doppler sonogram shows round hypoechoic mass. Doppler flows representing vascular hilum are visualized in mass.

 


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  		Fig. 1E. —45-year-old woman with accessory spleen in transplanted pancreas. Coronal technetium-99m-labeled heat-damaged RBC SPECT scan shows accumulation of radionuclide (arrow) at mass in tail of transplanted pancreas.

 

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