thORACIC SPLENOSIS

Ectopic location of the splenic tissue might proceed in the form of accessory spleen or splenosis. As distinguished from the inborn character of the accessory spleen, the presence of the splenic tissue is of intentional (controlled autotransplantation) or intrinsic, posttraumatic character (1, 2, 3). The phenomenon of the splenic tissue autotransplantation was first described in dogs by Graffini and Tizzani in 1883 and the name splenosis was introduced into modern terminology by Buchbinder and Lipkoff in 1939 (1, 2, 4, 5, 6). The initiating condition for the creation of splenosis is the splenic injury with capsule damage and the spread of splenic tissue. Zieliński and partners revealed the presence of the focuses of splenosis in 73% of the rats subjected to splenectomy and splenic tissue implantation into the peritoneal cavity (6). Healing of the splenic tissue fragments both in experimental and clinical studies was also described in Polish literature by Badowski, orłowski and Ziarek (7, 8, 9). Intensification of the intrinsic implantation is ascribed to the degree of splenic fragmentation, the intensification of bleeding, the time period between the injury and its treatment, the local conditions and the use of intraoperative procedures, e.g. rinsing of the peritoneal cavity during the reconstruction (which limits the spread) and the frequency of the phenomenon is estimated at 67% (1, 6, 10, 11, 12). The process of implants reconstruction proceeds most intensively during the first 5 weeks and depends on the level of their blood supply (1, 6, 13, 14). Reactivation of the implanted splenic fragments was described in isotopic tests in the period from 6 weeks to 24 months although there is information about contradicFig. 1. View of the pleural splenosis with pleural vessels going to the focus from outside tory results (7, 8, 15, 16). The most frequent location for autotransplantation is the peritoneal cavity. The focuses of splenosis were also described within kidney, liver, pancreas and paravertebral locations as well as in a laparotomy scar (2, 5, 17-22). The focuses of splenosis within solid organs, in soft tissues of the left arm and, especially, the intracranial focus of splenosis described by Rickert might prove the haematogenous character of the implants although it has not been confirmed unequivocally with experimental studies (23-26).