From the Research
An accessory splenule on ultrasound is a common anatomical variant found in approximately 10-30% of the population and is typically benign, requiring no treatment or intervention. This condition is characterized by a small, additional mass of splenic tissue that is separate from the main spleen, usually small (less than 2 cm in diameter), round or oval-shaped structures that have the same echogenicity (appearance on ultrasound) as normal splenic tissue 1. They are most commonly located near the hilum of the spleen, in the splenic ligaments, or in the tail of the pancreas, but can occasionally be found elsewhere in the abdomen.
Some key points to consider when evaluating an accessory splenule on ultrasound include:
- They develop during embryonic life when small portions of splenic tissue separate from the main organ during development 2
- They are generally asymptomatic and discovered incidentally during imaging studies performed for other reasons 3
- It's essential to distinguish accessory splenules from other pathological conditions such as lymphadenopathy, adrenal masses, or neoplasms 4
- In patients who have undergone splenectomy for conditions like immune thrombocytopenia, accessory splenules may continue to function and potentially affect treatment outcomes, so their identification can be clinically relevant in these specific cases 5
The diagnosis of an accessory splenule can be confirmed using various imaging modalities, including ultrasound, computed tomography (CT), and magnetic resonance imaging (MRI) 2. Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) can also be used to confirm the diagnosis of an accessory splenule, especially when it is located in the pancreas or stomach wall 1, 5. In summary, the presence of an accessory splenule on ultrasound is usually a benign finding that does not require treatment, but it's crucial to differentiate it from other pathological conditions to avoid unnecessary interventions.