False-Positive Splenic Imaging Secondary to Cavernous Transformation of the Portal Venous System in Non-Hodgkin's Lymphoma

A SPECT scan of the abdomen performed using Tc-99m-labeled heat-damaged red blood cells (HDRBCs) showed increased activity in the left upper quadrant thought to represent accessory splenic tissue in this patient after splenectomy. Further evaluation revealed this to be a false-positive finding most likely secondary to cavernous transformation of the portal venous system. Although HDRBCs are sequestered by the spleen, a considerable portion remain in the circulating blood pool. Thus, increased activity may be seen secondary to increased local blood volumes in networks of dilated vessels.