Monday, February 17, 2014


A man in his 30s is dropped off unconscious with multiple gunshot wounds. He is taken to the operating room where he has an exploratory laparotomy, total splenectomy, bowel resection, diaphragmatic repair, and bladder repair. Post-operatively, he leaves against medical advice and is lost to follow-up. He never gets any vaccinations.

Years later, he signs up for a research study for some money. A thoracic CT scan is performed which shows some lung nodules. He is a lifetime nonsmoker.

He decides to go to a physician and gets a heat-damaged RBC scintogram, shown below.

The rest of his review of systems is negative. Other than the gunshot wounds, he's never been sick a day in his life.

Challenge: What's going on?

Images shown under Fair Use.


Alex said...


tree said...


Craig Chen said...

yep! nice job! kind of a cool disease

This is thoracic splenosis caused by implantation of splenic tissue in other areas of the body including the thorax, abdomen, and pelvis. Splenic tissue takes up damaged RBCs from the circulation. Splenosis can provide some degree of splenic immunocompetence.

Sources: UpToDate;