Intrahepatic Splenosis in a Patient with Autoimmune Hepatitis with No History of Splenectomy or Abdominal Trauma

Splenosis should be suspected when a patient has a history of trauma or abdominal surgery. Intrahepatic splenosis is a rare disease that is often difficult to distinguish from liver malignancy, especially hepatocellular carcinoma. The cause of intrahepatic splenosis may be though the auto-transplantation of splenic tissue on the surface of the liver. The authors report a case of intrahepatic splenosis that presented as a liver tumour in an 81-year-old female treated for autoimmune hepatitis, who had no history of splenectomy or abdominal trauma. Laparoscopic hepatectomy was performed and the specimen demonstrated characteristic histopathological findings of the spleen. Only one case of a patient who had no history of splenectomy or abdominal trauma has been reported in the literature. It may be hypothesised that erythropoiesis induced by local hypoxia in the chronic hepatitis may cause the growth of splenic erythrocytic progenitor cells, which have migrated via portal vein to the liver.