Splenomegaly generally denotes a palpably enlarged spleen. However, it may also refer to an enlarged spleen detected by an imaging test. It is not uncommon for a radiologist interpreting a chest x-ray to comment that the spleen seems enlarged (usually considered an incidental finding). Splenomegaly can be found in 3% of the general population.
人体脾脏平均长 10 cm，重 150 g。 It may be difficult to palpate an enlarged spleen in the settings of obesity, a muscular abdominal wall, or the inability to sufficiently relax the abdominal musculature. In these cases, spleen size may need to be determined by imaging.
脾肿大患者的阶梯式算法很难创建。 Urgent presentations include sudden pain associated with splenomegaly, splenic sequestration crisis of sickle cell anaemia, and splenic vein or portal vein thrombosis. Otherwise presentation is often incidental on physical examination or imaging. Categorisation by presentations such as massive splenomegaly, isolated splenomegaly, or accompanying symptoms could be considered. However, these categories encompass diverse diagnoses. For example, thalassaemia, chronic myeloid leukaemia, Gaucher's disease, hairy cell leukaemia, myelofibrosis, and malaria may all present with a markedly enlarged spleen. Isolated splenomegaly is a feature of diagnoses such as splenic marginal lymphoma or benign splenic neoplasms. Accompanying symptoms are non-specific; for example, fever may occur with lymphomas, malaria, endocarditis, or infectious mononucleosis.
- 原发性胆汁性胆管炎 (PBC)
- 非霍奇金淋巴瘤 (NHL)
- 急性髓系白血病 (AML)
- 慢性髓细胞性白血病 (CML)
- 急性淋巴细胞性白血病 (ALL)
- 慢性淋巴细胞性白血病 (CLL)
- 类风湿性关节炎 (RA)
- Felty 综合征
- 爱泼斯坦-巴尔病毒 (EBV)
- 噬血细胞性淋巴组织细胞增生症 (HLH)
- 继发于粒细胞集落刺激因子 (G-CSF)
Terri L. Parker, MD
Assistant Professor of Medicine
Section of Hematology
Yale School of Medicine
Smilow Cancer Center at Yale-New Haven
TLP declares that she has no competing interests.
Dr Terri L. Parker would like to gratefully acknowledge Dr Alan E. Lichtin, the previous contributor to this monograph.
AEL has received research support from Amgen.
Priyanka Mehta, MD
Bristol Haematology and Oncology Centre
PM declares that she has no competing interests.
Ruben A. Mesa, MD
Professor of Medicine
RAM declares that he has no competing interests.
Giovanni Barosi, MD
Director of the Laboratory of Clinical Epidemiology
IRCCS Policlinico S. Matteo Foundation
GB declares that he has no competing interests.