Increased Incidence of Accessory Spleens in Hematologic Disease

Abstract

Despite their small size, accessory spleens are clinically important. Hematologists have long emphasized their occasional role in the reexacerbation of hematologic disease after initially beneficial splenectomy.^1-7Accessory spleens have been known to rupture,⁸twist on their pedicles and strangulate,^5,6,9cause bowel obstruction,¹⁰and produce defects on upper gastrointestinal radiographs suggestive of gastric neoplasms.^11,12Although accessory spleens are well recognized as a<i>cause</i>of disease, there is little published evidence to suggest that their apparent frequency may be the<i>result</i>of disease. Anatomy textbooks tend to mention the infrequent presence of accessory spleens as an anatomic fact devoid of pathological significance. Settle states, "the accessory spleen is an anomaly [which is the] result of a development abnormality in the embryo."⁶Downey¹³and Arey¹⁴share this belief. To some degree this is true, as substantiated by the occasional presence of accessory spleens in normal