Friday, 3 July 2009

Massive splenomegaly

Massive splenomegaly, as opposed to just your 'everyday' splenomegaly has been defined in several ways. The easiest of these to remember is is probably a spleen that extends to more than 8 cm below the left costal margin. This roughly corresponds to a spleen lying below the level of the umbilicus. In case the spleen enlarges abnormally (for instance, in some haematological malignancies), massive splenomegaly status could also be said to be achieved if it crosses the midline and extends into the right half of the abdomen.

The list of aetiological possibilities when it comes to simple splenomegaly is truly massive, but fortunately the list shrinks quite a bit if the spleen attains "massive" status. Sources disagree, but the most commonly-named disorders giving rise to this condition are probably:
  • Chronic myeloid leukaemia
  • Myelofibrosis
  • Lymphoma
  • Thalassaemia major or intermedia
  • Gaucher's disease
  • Leishmaniasis
  • Tropical splenomegaly
It's quite hard to think of a memory aid for this list. There's lymphoma, one leukaemia, one myeloproliferative disorder, one haemoglobinopathy, one metabolic storage disease, one infection and one idiopathic condition. Any suggestions?

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