An 86-year-old man with a history of polyarteritis nodosa on long-term corticosteroid therapy and prior splenic rupture requiring surgery presented with asthenia, low-grade fever, and jaundice. A CT scan demonstrated multiple hepatic lesions, interpreted as possible intrahepatic splenosis or metastases (Fig. 1A). However, the presence of Howell-Jolly bodies on peripheral blood smear argued against splenosis. An ultrasound-guided liver biopsy was performed, but it was inconclusive and was complicated by intra-abdominal hemorrhage.
