Splenomegaly
The spleen must be enlarged to about three times its normal size before it becomes clinically palpable. The lower margin may feel notched on palpation. The spleen may become so massive in size that it is palpable in the right iliac fossa. Massive splenomegaly in the UK is likely to be due to chronic myeloid leukaemia, myelofibrosis or lymphoma. Splenomegaly may lead to hypersplenism, i.e. pancytopenia as cells become trapped and destroyed in an overactive spleen.
Causes
Infective
Neoplastic
• Lymphoma
Figure 58 MRI (sagittal section) of a patient with gross splenomegaly due to chronic myeloid leukaemia.
The spleen (arrow) fills virtually the whole of the abdominal cavity. Because of the size of the spleen, the patient could not sit upright.
Haemolytic Disease
NON-PARASITIC CYSTS
