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Myelofibrosis (massive splenomegaly with infarct)

Case contributed by Henry Knipe
Diagnosis almost certain

Presentation

Abdominal pain.

Patient Data

Age: 55 years
Gender: Male

Massive splenomegaly with multiple infarcts of differing ages. Hepatomegaly.

Prominent mesenteric vessels likely from venous engorgement given the dilated splenic and portal veins. Small volume of pelvic free fluid.

Diffuse bony sclerosis.

Case Discussion

This case demonstrates some of the imaging features of myleofibrosis:

  • diffuse bony sclerosis
  • massive splenomegaly with its complications:
    • splenic infarct
    • portal hypertension from increased splenic venous return

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