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Splenomegaly refers to enlargement of the spleen. The upper limit of normal adult splenic length is traditionally cited at 12 cm, but lengths upwards of 14 cm can be seen in normal, taller males 7.

Massive splenomegaly is variably defined, including when the spleen is 5 standard deviations above the mean normal volume (about 943 cm34, heavier than 1000 g 5 or 1500 g 8, longer than 18 cm 8, or extending into the pelvis or across midline 4.

The causes of splenomegaly are protean, and can be thought of under a number of headings 3,8:

  • hematological disease
  • hemodynamic
  • infectious
  • storage diseases/metabolic/infiltrative disorders
  • neoplastic (non-hematologic)
  • traumatic
  • connective tissue disorders

* may cause massive splenomegaly 3,8

The shape and orientation of a spleen make accurate linear measurement difficult.

On CT, a splenic width measurement (largest anterior-posterior measurement on axial images) of greater than 10.5 cm is the most accurate single measurement for mild to moderate splenomegaly in patients with cirrhosis; while a craniocaudal measurement of greater than 14.6 cm is the most accurate single measurement for massive splenomegaly 4.

On sonographic assessment, a length of 12 cm is generally considered the upper limit of normal. 

Article information

rID: 6003
Section: Gamuts
Synonyms or Alternate Spellings:
  • Moderate splenomegaly
  • Massive splenomegaly
  • Splenomegalic
  • Splenic enlargement
  • Enlarged spleen
  • Enlargement of the spleen

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Cases and figures

  • Figure 1: splenic deposits in CLL
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  • Case 1
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  • Case 3
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  • Case 2
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  • Case 4 : with splenic infarct
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  • Splenic Infarctio...
    Case 5 : CML with splenic Infarction
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  • Hepatosplenomegal...
    Case 6 : CML with massive splenommegaly
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  • Homogeneous splen...
    Case 7 : on ultrasound
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  •  Case 8 : lymphoma
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  • Case 9: myelofibrosis
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  • Case 10: on abdominal x-ray
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  • Case 11: with sickle cell disease
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  • Case 12: with leukemia
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  • Case 13: Lymphoma: Lugano classification
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  • Gaucher splenomeg...
    Case 14 : Gaucher disease
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  • Case 16
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  • Splenomegaly and ...
    Case 15 : Wilson's disease and cirrhosis
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  • Case 17
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