Splenomegaly

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Splenomegaly is a term which refers to enlargement of the spleen. The normal adult splenic length upper limit is usually around 12-15 cm.

Pathology

The causes of splenomegaly are protean, and can be thought of under a number of headings:

haematological disease
haemodynamic
infectious
storage diseases/metabolic diseases
neoplastic (non-haematologic)
traumatic
connective tissue disorders

Haematological disease

anaemias
neoplastic/proliferative/redistribution of haematopoesis
- leukaemia(especially CML*)
- polycythaemia rubra vera ~~(PRV)~~ *
- Waldenström macroglobulinaemia
- myelofibrosis *
- extramedullary haematopoiesis
- osteopetrosis
- idiopathic hypereosinophilic syndrome

Haemodynamic

cirrhosis: portal hypertension (common)
congestive splenomegaly (Banti syndrome)
splenic vein obstruction
portal vein obstruction
right heart failure

Infection

viral
- EBV (infectious mononucleosis) - (common)
- AIDS
- CMV
- herpes simplex virus
- rubella
bacterial
- tuberculosis(miliary)
- tularemia
- subacute bacterial endocarditis
- typhoid fever
- brucellosis
- syphilis
- abscess
fungal
- histoplasmosis: (common)
- candidiasis
parasitic disease
- malaria *
- schistosomiasis
- hydatid disease
- leishmaniasis~~(kala~~ kala-azar)
rickettsial
- typhus

Storage diseases/metabolic/infiltrative disorders

Neoplastic (non-haematologic)

lymphoma: (common)
metastases (breast, lung, colon, ovary, melanoma)
haemangioma
lymphangioma
angiosarcoma

Trauma

haematoma
pseduocyst

Connective tissue disorders

* = may cause massive splenomegaly³

Radiographic features

The shape and orientation of a spleen makes accurate linear measurement difficult. On sonographic assessment, a length of 12 cm is generally considered the upper limit of normal.

~~-<a href="/articles/leukaemia">leukaemia </a>(especially <a href="/articles/cml">CML</a>*)</li>~~
+<a href="/articles/leukaemia">leukaemia</a> (especially <a href="/articles/cml">CML</a> *)</li>
~~-<a href="/articles/polycythaemia-rubra-vera">polycythaemia rubra vera (PRV)</a> *</li>~~
~~-<li><a href="/articles/waldenstr-m-macroglobulinaemia">Waldenström macroglobulinaemia</a></li>~~
+<a title="polycythaemia rubra vera" href="/articles/polycythaemia-rubra-vera">polycythaemia rubra vera</a> *</li>
+<li><a title="Waldenstrom macroglonulinaemia" href="/articles/waldenstrom-macroglonulinaemia">Waldenström macroglobulinaemia</a></li>
~~-<a href="/articles/tb">tuberculosis </a>(miliary)</li>~~
+<a href="/articles/tb">tuberculosis</a> (miliary)</li>
~~-<a href="/articles/histoplasmosis">histoplasmosis</a>: (common)</li>~~
+<a title="histoplasmosis" href="/articles/histoplasmosis">histoplasmosis</a> (common)</li>
~~-<a href="/articles/leishmaniasis">leishmaniasis </a>(kala-azar)</li>~~
+<a href="/articles/leishmaniasis">leishmaniasis</a> kala-azar)</li>

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