‘Liver Tail’ Pseudospleen Appearance in Denatured Erythrocyte Scintigraphy with Computed Tomographic and Magnetic Resonance Correlations

A patient had thrombocytopenia 15 years after splenectomy for idiopathic thrombocytopenia. A liver–spleen scan was requested to identify possible splenic regrowth. Heat-denatured erythrocyte scintigraphy showed normal hepatic activity, with increased radiotracer activity in the splenic bed, possibly representing significant splenic regrowth. However, both computed tomographic and magnetic resonance images of the abdomen confirmed that the scintigraphic findings represented contiguous tissues arising from the left lobe of the liver, giving a “liver-tail” appearance with all imaging methods. There was no evidence of splenosis elsewhere. Pseudospleen appearance on labeled erythrocyte studies is a potential problem in patients after splenectomy.