Splenomegaly is commonly diagnosed on imaging studies. There are many causes of splenomegaly. Some patients may have transient enlargement from an illness while others may have serious disease and chronic enlargement of the spleen. Imaging can sometimes identify the cause of splenomegaly but more extensive testing is sometimes needed.
What are the functions of the spleen?
The spleen functions primarily by filtering the blood and removing old or damaged blood cells. The spleen also helps fight infections.
What is splenomegaly?
Splenomegaly is when the spleen becomes enlarged. We define this is either by weight of the spleen and on imaging studies by the size. The size of the spleen also varies by weight, height and sex. Men, taller and heavier patients will often have larger spleens.
Symptoms of enlarged spleen
Symptoms are most common from the underlying cause of the splenomegaly. Patients can also have abdominal pain, distended abdomen, bloating and loss of appetite.
How is splenomegaly diagnosed?
Splenomegaly is diagnosed by either an examination by the physician or on imaging studies. Splenomegaly on imaging studies may be defined by the length of the spleen or volume.
What does splenomegaly look like on imaging?
Splenomegaly is an enlarged spleen on imaging. Measurements are often needed to be sure.
What else can look like splenomegaly in radiology?
Splenomegaly can be caused by many underlying disorders. Mild splenomegaly can sometimes be the result of a tall or heavy patient alone.
What causes enlarged spleen?
Liver disease is one of the most common causes. Blood work and dedicated liver imaging can help diagnose hepatitis and cirrhosis.
Infections with various organisms can cause enlargement of the spleen. Examples would include endocarditis, tuberculosis and HIV.
Cancers of the blood like leukemia and lymphoma can enlarge the spleen.
Cytopenias can be caused by a destruction of blood cells by the immune system. This can lead to enelagarment of the spleen.
Autoimmune diseases like rheumatoid and lupus can be associated with an enlarged spleen.
Infiltrative disorders like amyloidosis and sarcoidosis.
Splenic masses like large cysts or solid masses can enlarge the spleen.
Clots in the veins of the liver can cause congestion and enlargement of the spleen.
Congestion of the spleen from heart failure or portal hypertension.
Can imaging tests tell us why the spleen is enlarged?
Sometimes a more extensive workup is needed to include careful history, physical exam, blood work, biopsies and additional testing.
Imaging tests can sometimes provide a cause for splenomegaly. For example, we may notice a cirrhotic liver on CT which can cause splenomegaly. We may see enlarged lymph nodes in the body when there is a cancer like lymphoma.
Is splenomegaly dangerous?
It depends on the cause. There are many life threatening causes of Splenomegaly that need prompt diagnosis and treatment.
In any case, an enlarged spleen is at danger of rupture which can be life threatening.
What type of doctor treats enlarged spleen?
It depends on the underlying cause. For example, cancers of the blood may be treated by a hematology oncology specialist.
Liver disease may be treated by a hepatologist or liver specialist.
Heart failure causing splenomegaly may be treated by a cardiologist or heart specialist.
Enlarged spleen treatment
The treatment of an enlarged spleen will depend on the underlying cause.
Splenomegaly (enlarged spleen): summary
Splenomegaly is often diagnosed on imaging. There are many causes of splenomegaly (see above). Many can be life threatening and need prompt diagnosis and treatment. The cause of splenomegaly can sometimes be identified on imaging tests.