Thoracic splenosis: correct imaging diagnosis prevents invasive procedures like biopsy and thoracoscopy

Description 

A 48-year-old woman presented to the emergency department with acute shooting type of left-sided chest pain. There was no radiation of the pain to the arm, no aggravating or relieving factors. The patient denied cough, haemoptysis or weight loss. Medical history was significant for stage 2 breast carcinoma treated with radical mastectomy and radiotherapy 5 years ago. Since then she was on hormone therapy with tamoxifen. Investigations including routine blood counts, ECG and cardiac enzymes were normal. Chest radiograph did not reveal any abnormalities. CT scan of the chest with intravenous contrast revealed three enhancing pleural  based masses in the left hemithorax, measuring up to 2.6 cm in size. Initial diagnosis was pleural metastases from breast carcinoma and biopsy was considered. But the images also revealed bullet fragment in the thoracic spine and postsurgical changes of splenectomy. This raised the suspicion that the pleural masses could be due...

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