Implantation of splenic fragments onto the pleural following trauma can result in a splenosis that may be mistaken for a malignant tumor.
Features of pleural splenosis:
(1) The patient has a past history of abdominal trauma, which may be remote. This is especially significant if there was traumatic rupture of the spleen.
(2) There is a defect in the diaphragm (which may be traumatic) that gives splenic fragments access to the pleura, primarily on the left side.
(3) The focus of splenic tissue may be detected on an imaging study. If the diagnosis is suspected then the diagnosis can be made by radionuclide uptake studies.
(4) Biopsy of the mass shows splenic tissue with red and white pulp.
Often there is a single mass but more than one may be present.
In theory the tissue could be involved by malignant lymphoma or any other condition affecting the spleen, but the rarity of the condition makes this unlikely.
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