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An Uncommon Image of Spleen

An Uncommon Image of Spleen IMAGES IN THE MEDICAL SCIENCES Alper Alp, MD Division of Nephrology Van Education and Research Hospital, Van, Turkey (E-mail: alperalp20@hotmail.com) The author has no financial or other conflicts of interest to disclose. FIGURE 1. Contrast-enhanced computed tomography, FIGURE 2. Contrast-enhanced computed tomography, sagittal plane coronal plane first minute after the intravenous injection of contrast material. 25-year-old man was admitted to the hospital because of This “early” timing is accepted to be related to the arterial A high blood pressure unresponsive to initial therapy. Except phase of contrast enhancement. The presence of heteroge- for hypertension, his medical history revealed thalassemia trait. neous splenic enhancement may also rarely be attributed to Physical examination on admission revealed a normal general the presence of splenic laceration, chronic or acute liver dis- condition, blood pressure 155/95 mm Hg and a regular pulse of ease, portal vein thrombosis, splenic lymphoma, and heart 82 beats/min. Physical examination revealed no hepatomegaly failure. These entities were ruled out during the evaluation. or splenomegaly. Laboratory investigations did not indicate Such a radiological finding of spleen on computed tomogra- a specific condition. Further examinations were planned for phy may confuse the diagnostic workup in a patient, and this investigating secondary hypertension etiologies due to the phenomenon shouldbekeptinmindbeforemakingfurther young age. After the contrast-enhanced computed tomography investigations. of the abdomen was performed, an interesting image of the spleen was detected and described as an archiform pattern of REFERENCES heterogeneous enhancement (Figures 1 and 2). 1. Nouvini R, Hapani S. Images in clinical medicine. Enlarged spleen with Heterogeneous splenic enhancement is not a patholog- 1 a heterogeneous pattern. N Engl J Med 2013;368:e37. ical and radiological finding and is usually transient. The difference in the degree of attenuation seems to be responsible 2. Urban BA, Fishman EK. Helical CT of the spleen. AJR Am J Roent- for this entity. It can occur when imaging is performed in the genol 1998;170:997–1003. The American Journal of the Medical Sciences Volume 0, Number 0, Month 2015 Copyright  2015 by the Southern Society for Clinical Investigation. Unauthorized reproduction of this article is prohibited. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png American Journal of the Medical Sciences Wolters Kluwer Health

An Uncommon Image of Spleen

Alp, Alper
American Journal of the Medical Sciences , Volume Publish Ahead of Print – Sep 1, 2015
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Copyright
Copyright © 2015 by the Southern Society for Clinical Investigation.
ISSN
0002-9629
eISSN
1538-2990
DOI
10.1097/MAJ.0000000000000566
Publisher site
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Abstract

IMAGES IN THE MEDICAL SCIENCES Alper Alp, MD Division of Nephrology Van Education and Research Hospital, Van, Turkey (E-mail: alperalp20@hotmail.com) The author has no financial or other conflicts of interest to disclose. FIGURE 1. Contrast-enhanced computed tomography, FIGURE 2. Contrast-enhanced computed tomography, sagittal plane coronal plane first minute after the intravenous injection of contrast material. 25-year-old man was admitted to the hospital because of This “early” timing is accepted to be related to the arterial A high blood pressure unresponsive to initial therapy. Except phase of contrast enhancement. The presence of heteroge- for hypertension, his medical history revealed thalassemia trait. neous splenic enhancement may also rarely be attributed to Physical examination on admission revealed a normal general the presence of splenic laceration, chronic or acute liver dis- condition, blood pressure 155/95 mm Hg and a regular pulse of ease, portal vein thrombosis, splenic lymphoma, and heart 82 beats/min. Physical examination revealed no hepatomegaly failure. These entities were ruled out during the evaluation. or splenomegaly. Laboratory investigations did not indicate Such a radiological finding of spleen on computed tomogra- a specific condition. Further examinations were planned for phy may confuse the diagnostic workup in a patient, and this investigating secondary hypertension etiologies due to the phenomenon shouldbekeptinmindbeforemakingfurther young age. After the contrast-enhanced computed tomography investigations. of the abdomen was performed, an interesting image of the spleen was detected and described as an archiform pattern of REFERENCES heterogeneous enhancement (Figures 1 and 2). 1. Nouvini R, Hapani S. Images in clinical medicine. Enlarged spleen with Heterogeneous splenic enhancement is not a patholog- 1 a heterogeneous pattern. N Engl J Med 2013;368:e37. ical and radiological finding and is usually transient. The difference in the degree of attenuation seems to be responsible 2. Urban BA, Fishman EK. Helical CT of the spleen. AJR Am J Roent- for this entity. It can occur when imaging is performed in the genol 1998;170:997–1003. The American Journal of the Medical Sciences Volume 0, Number 0, Month 2015 Copyright  2015 by the Southern Society for Clinical Investigation. Unauthorized reproduction of this article is prohibited.

Journal

American Journal of the Medical Sciences – Wolters Kluwer Health

Published: Sep 1, 2015

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