In a patient with ectopic splenic tissue causing symptomatic mass effect in the pelvis, would you approach radiation differently than you would splenomagaly due to a hematologic malignancy?  

Yes, I would approach radiation differently. I would not choose to electively irradiate a patient with a splenunculus/splenunculi.  If the ectopic splenic tissue is large enough to be causing mass effect or is otherwise anatomically situated so as to be causing other issues (e.g. acting as a l...