Diagnosis of Perihepatic Splenosis Using ¹⁸F-FDG and ⁶⁸Ga- FAPI-04 PET Imaging in a Post-Splenectomy Patient

Xinwei Cheng, Haiyan Wang, Jianjuan Jiang, Jie Ding#* and Jun Zhao#*

Department of Nuclear Medicine, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China #These authors contributed equally to this work

^*Correspondance to: Jie Ding; Jun Zhao 

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Abstract:

Perihepatic splenosis is a rare variant of splenosis, characterized by the heterotopic implantation of splenic tissue within the liver parenchyma following splenic trauma or splenectomy. A 74-year-old woman with a history of hepatitis B was found to have liver cirrhosis and multiple peripheral lesions on the liver. Her medical history includes a diagnosis of left submandibular lymphoma 25 years ago and a total splenectomy due to chemotherapy-related splenic hyperfunction and thrombocytopenia. She subsequently underwent 18F-FDG PET/CT and 68Ga-FAPI-04 PET/MR to rule out potential malignant lesions. The isometabolic FDG metabolism and mildly elevated FAPI uptake suggested the possibility of benign lesions, and the final pathological diagnosis was perihepatic splenosis. This case highlights the need for awareness of splenosis in patients with a history of splenectomy.

Keywords:

¹⁸F-FDG, ⁶⁸Ga-FAPI, PET, perihepatic splenosis

Cite the Article:

Cheng X, Wang H, Jiang J, Ding J, Zhao J. Diagnosis of Perihepatic Splenosis Using ¹⁸F-FDG and ⁶⁸Ga- FAPI-04 PET Imaging in a Post- Splenectomy Patient. Ann Clin Case Rep. 2025; 10: 2737..