Imaging and Diagnosis of Accessory Spleen Anomalies

Accessory spleens are congenital foci of splenic tissue separate from the main organ, encountered in up to 11 per cent of the population. While typically asymptomatic, these ectopic nodules may mimic neoplastic lesions or hypertrophy after splenectomy, leading to diagnostic uncertainty and sometimes unnecessary surgery. Imaging modalities play a pivotal role in identification and characterisation: ultrasonography provides initial detection; multidetector computed tomography (MDCT) delineates morphology, location and enhancement patterns; magnetic resonance imaging offers superior soft-tissue contrast; endoscopic ultrasound with fine-needle aspiration (EUS-FNA) permits cytological assessment; and nuclear medicine techniques, including technetium-99m colloid or erythrocyte scintigraphy, confirm splenic tissue by radiotracer uptake. Recognition of typical enhancement kinetics, anatomical distribution—most commonly at the splenic hilum or pancreatic tail—and the possibility of cystic transformation within an accessory spleen informs accurate differential diagnosis and prevents overtreatment. Recent advances in contrast-enhanced ultrasound and hybrid positron emission tomography/MRI continue to refine sensitivity and specificity in challenging presentations.

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Imaging and Diagnosis of Accessory Spleen Anomalies publication trend

The graph below shows the total number of articles in imaging and diagnosis of accessory spleen anomalies across all publications each year (not limited to Nature Index journals).

Technical terms

Accessory spleen: Congenital ectopic splenic tissue separate from the primary organ.

Intrapancreatic accessory spleen (IPAS): An accessory spleen located within the pancreatic parenchyma, often in the tail.

Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA): A minimally invasive procedure using high-frequency ultrasound and needle biopsy to sample lesions adjacent to the gastrointestinal tract.

Multidetector computed tomography (MDCT): High-resolution CT imaging employing multiple detector rows to rapidly capture thin-slice images for detailed anatomical assessment.

References

1. Solid and cystic intrapancreatic accessory spleen: report of 10 cases in a single institution. Annals of Medicine (2025).
2. Epidermoid cyst in an intrapancreatic accessory spleen diagnosed by contrast-enhanced EUS and EUS-FNA (with video). Endoscopic Ultrasound (2024).
3. The accessory spleen: prevalence and imaging findings in 1735 consecutuve patients examined by multidetector CT. Journal of the Belgian Society of Radiology (2012).