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CT Features of the Accessory Spleen

Koenraad J. Mortelé1, Bart Mortelé2 and Stuart G. Silverman1

1 Division of Abdominal Imaging and Intervention, Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, 75 Francis St., Boston, MA 02115.
2 Department of Radiology, Ghent University Hospital, De Pintelaan 185, Ghent B-9000, Belgium.



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  		Fig. 1A. —Anatomic drawings of spleen. Locations of axial (A), coronal (B), and sagittal (C) accessory spleens are derived by dividing left upper quadrant into discrete anatomic compartments. This was done by drawing line perpendicular to longest axis of main spleen at level of spenic hilum, resulting in anteromedial (AM), anterolateral (AL), posteromedial (PM), and posterolateral (PL) compartments. Craniocaudally, main spleen was divided into superior third, middle third, and inferior third. When accessory spleen was located anterior (A) to or posterior (P) to main spleen, area was again divided into superior third, middle third, and inferior third. Accessory spleens outside this region were considered either superior (S) to or inferior (I) to main spleen.

 


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  		Fig. 1B. —Anatomic drawings of spleen. Locations of axial (A), coronal (B), and sagittal (C) accessory spleens are derived by dividing left upper quadrant into discrete anatomic compartments. This was done by drawing line perpendicular to longest axis of main spleen at level of spenic hilum, resulting in anteromedial (AM), anterolateral (AL), posteromedial (PM), and posterolateral (PL) compartments. Craniocaudally, main spleen was divided into superior third, middle third, and inferior third. When accessory spleen was located anterior (A) to or posterior (P) to main spleen, area was again divided into superior third, middle third, and inferior third. Accessory spleens outside this region were considered either superior (S) to or inferior (I) to main spleen.

 


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  		Fig. 1C. —Anatomic drawings of spleen. Locations of axial (A), coronal (B), and sagittal (C) accessory spleens are derived by dividing left upper quadrant into discrete anatomic compartments. This was done by drawing line perpendicular to longest axis of main spleen at level of spenic hilum, resulting in anteromedial (AM), anterolateral (AL), posteromedial (PM), and posterolateral (PL) compartments. Craniocaudally, main spleen was divided into superior third, middle third, and inferior third. When accessory spleen was located anterior (A) to or posterior (P) to main spleen, area was again divided into superior third, middle third, and inferior third. Accessory spleens outside this region were considered either superior (S) to or inferior (I) to main spleen.

 


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  		Fig. 2. —Axial contrast-enhanced CT image in 32-year-old man with Crohn's disease shows large accessory spleen (arrow), measuring 2 cm anteroposteriorly and transversely.

 


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  		Fig. 3. —Axial contrast-enhanced CT image in 52-year-old man with evaluated for left renal cyst shows small accessory spleen (arrowhead) measuring 2 mm that is hypodense to spleen.

 


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  		Fig. 4. —Axial contrast-enhanced CT image in 64-year-old woman with abnormal liver function tests shows ovoid accessory spleen (arrow).

 


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  		Fig. 5. —Axial contrast-enhanced CT image in 46-year-old woman with left lower quadrant pain shows round accessory spleen (arrow).

 


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  		Fig. 6. —Axial contrast-enhanced CT image in 70-year-old man with metastatic colon cancer shows triangular accessory spleen (arrow).

 


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  		Fig. 7. —Axial contrast-enhanced CT image in 29-year-old woman with ovarian dermoid shows most frequent location of accessory spleen in posteromedial compartment (arrow).

 


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  		Fig. 8. —Axial contrast-enhanced CT image in 60-year-old man with diverticulitis shows unusual location of accessory spleen in anterolateral compartment.

 


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  		Fig. 9. —Axial contrast-enhanced CT image in 66-year-old man with epigastric pain shows intrapancreatic accessory spleen (arrow).

 

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