Splenomegaly
Dr Jan Frank Gerstenmaier and Dr Frank Gaillard et al.
Splenomegaly is a term which refers to enlargement of the spleen. The normal adult splenic length upper limit is usually around 12 - 15 cms.
The shape and orientation of a spleen makes accurate linear measurement difficult. On sonographic assessment, a length of 12 cms is generally considered the upper limit of normal.
The causes of splenomegaly are protean, and can be thought of under an 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
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
- sub acute bacterial endocarditis
- typhoid fever
- brucellosis
- syphilis
- abscess
- fungal
- histoplasmosis : (common)
- candidiasis
- parasitic disease
- malaria *
- schistosomiasis
- hydatid disease
- leishmaniasis (kala-azar)
- rickettsial
- typhus
Storage diseases / metabolic / infiltrative disorders
- Gaucher disease
- glycogen storage disease
- mucopolysaccharidoses
- Niemann-Pick disease
- haemochromatosis
- amyloidosis
- porphyria
- sarcoidosis
Neoplastic (non-haematologic)
- lymphoma : (common)
- metastases (breast, lung, colon, ovary, melanoma)
- haemangioma
- lymphangioma
- angiosarcoma
Trauma
- haematoma
- pseduocyst
Connective tissue disorders
* = may cause massive splenomegaly 3
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