Splenic infarction

Discussion:

This case demonstrates hepatosplenomegaly with splenic infarction.

Myelofibrosis is a clonal stem cell disorder characterized by splenomegaly, chronic myeloproliferation, bone marrow infiltration, and extramedullary hematopoiesis (EMH) 1. It commonly presents with anemia, palpable splenomegaly, and constitutional symptoms. Hepatosplenomegaly is a complication of significant extramedullary hematopoiesis 2. Hepatomegaly and splenomegaly are seen in up to 40-70% and 90% of patients respectively 3.

Splenic infarction in myelofibrosis results from a combination of infiltration of the splenic parenchyma in EMH, anemia and increased oxygen requirements of an enlarged spleen. 

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