PMC6424060_01
(A) Axial and coronal CT arterial phase images show an arterially enhancing intraparenchymal pancreatic tail lesion (arrows) (B) and (C) Axial PET and PET/CT images FDG (1b) show no uptake in the pancreatic tail lesion whilst the DOTATATE (1c) images show increased somatostatin receptor expression in the pancreatic tail lesion (arrows).
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Tomography (CT) of the thorax, abdomen and pelvis demonstrated a hypervascular lesion within the pancreatic tail and an indeterminate left upper lung nodule (Fig. 1A). The pancreatic lesion appeared to arising from the pancreatic parenchyma with no fat plane separation. Both the pancreatic lesion and lung nodule demonstrated no fluorodeoxyglucose (FDG) avidity (Fig. 1B). Ga68 DOTATATE PET/CT demonstrated a somatostatin receptor positive small pancreatic lesion that consistent with a well differentiated NET (Fig. 1C).
A: Macroscopic examination of the intra-pancreatic nodule revealed features resembling splenic tissue with the presence of Malpigian corpuscles within a vascular red pulp background. B: Histological examination showed encapsulated splenic tissue with normal red and white pulp.
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Histological analysis revealed a splenunculus (accessory spleen) within the pancreatic tail (Fig. 2).