OLD WOUNDS RUN DEEP: A CASE OF THORACIC SPLENOSIS FOLLOWING REMOTE TRAUMA

TOPIC: Disorders of the Pleura TYPE: Medical Student/Resident Case Reports INTRODUCTION: Thoracic splenosis develops as a result auto-transplantation splenic tissue into thoracic cavity following and diaphragmatic injury. Less than 40 cases have been reported in literature so far it remains an elusive diagnosis.[1] The majority were asymptomatic presented incidental findings on imaging. Few symptoms like pleuritic chest pain, hemoptysis, phrenic nerve irritation that prompted diagnostic workup. [2] We report one such case which young female with penetrating abdominal trauma unexplained shortness breath was diagnosed splenosis. CASE PRESENTATION: Our patient is 32-year-old who for evaluation lung nodules found work-up recurrent dyspnea. She had previously treated suspected bronchitis, however, complained persistent exertional dyspnea, orthopnea, fatigue. denied any fever, chills, cough, pedal edema, or weight loss. history gunshot to abdomen resulted splenectomy 8 years prior presentation. Physical exam unremarkable bloodwork normal. Chest x-ray showed pleural irregularities computed tomography revealed nodularity left space. PET-CT faint uptake this area. Transthoracic biopsy pleura yielded acellular specimen. suspected, liver spleen imaging single-photon emission performed after injecting 5.7 mCi Tc-99m sulfur colloid. study multiple foci corresponding underlying soft lower pleura, wall, bilateral mesentery. A diagnosis secondary made. patient's spirometry normal she managed supportive care reassurance. DISCUSSION: can be challenging there significant lag between thoracoabdominal findings. Tc-99 m heat-damaged erythrocyte scan has high sensitivity specificity tissue, while colloid indium-111-labeled platelets are less sensitive alternatives. CT-guided biopsies needle aspirations typically poor yield increased risk bleeding. [4,5] As slow-growing, non-invasive, mostly asymptomatic, appropriate management observation Surgical removal carries morbidity only attempted patients severe, increasing size mass. [3] CONCLUSIONS: thorough imaging, but often undergo invasive procedures bronchoscopy surgery order rule out neoplasm. Pulmonologists should aware rare entity avoid unnecessary REFERENCE #1: Ha YJ, Hong TH, Choi YS. Splenosis Splenic Diaphragmatic Injury. Korean J Thorac Cardiovasc Surg. 2019;52(1):47-50. doi:10.5090/kjtcs.2019.52.1.47 #2: Le Bars F, Pascot R, Ricordel C, et al. splenosis: symptomatic case. Chin Traumatol. 2020;23(3):185-186. doi:10.1016/j.cjtee.2020.05.003 #3: Matthews A, Chesser M, Mand J, Thomas A. Growth Opportunity: Splenosis. Am Med. 2017;130(4):420-422. doi:10.1016/j.amjmed.2016.11.010 DISCLOSURES: No relevant relationships by Sukhmani Boparai, source=Web Response David Chambers, Deon Ford, Prathik Krishnan, Shreedhar Kulkarni, Jonathan Packer,