PMC4701808_01
Arterial phase of a T1 weighted MRI showing an inhomogeneous contrast enhancement of a suspect lesion of the pancreatic tail.
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In a subsequent MRI performed in 10/2014 the lesion had increased in size and now presented with some radiological features of a malignant tumor (Fig. 1).
Arterial phase of a contrast-enhanced CT scan. Intrapancreatic tumor (arrow) showing inhomogeneous contrast enhancement.
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Here, the lesion showed radiological characteristics of a neuroendocrine tumor (Fig. 2).
Arterial phase of a contrast-enhanced CT scan showing contrast enhancement (arrow) of a liver lesion.
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Moreover, the CT scan revealed a contrast-enhanced lesion of the liver for which malignancy could not be excluded (Fig. 3).
Dotatate PET-CT showing strong Tracer uptake in the suspect lesion of the pancreatic tail.
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To further characterize the pancreatic tumor a Dotatate PET-CT was performed which revealed strong Tracer-uptake of the pancreatic lesion, strongly suggesting a neuroendocrine tumor of the pancreatic tail (Fig. 4).
Histopathology of the resected pancreatic tissue: HE (A) staining suggesting an intrapancreatic accessory spleen, B: immunohistopathological CD20 (B) and CD3 (C) staining confirming the benign diagnose of an accessory spleen of the pancreatic tail.
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Surprisingly, the histopathological analysis revealed the pancreatic lesion being an intrapancreatic accessory spleen (Fig. 5) and the liver lesion being a hemangioma.