Assessment of splenomegaly

Last reviewed: 9 Apr 2025
Last updated: 11 Dec 2024

Summary

Differentials

Common

  • Alcohol induced
  • Hepatic steatosis
  • Primary biliary cholangitis (PBC)
  • Primary sclerosing cholangitis
  • Haemochromatosis
  • Hodgkin's lymphoma
  • Non-Hodgkin's lymphoma (NHL)
  • Waldenström's macroglobulinaemia or lymphoplasmacytic lymphoma
  • Acute myeloid leukaemia (AML)
  • Chronic myeloid leukaemia (CML)
  • Acute lymphoblastic leukaemia (ALL)
  • Chronic lymphocytic leukaemia (CLL)
  • Hairy cell leukaemia
  • Myelofibrosis
  • Polycythaemia vera
  • Essential thrombocytosis
  • Splenic metastases
  • Autoimmune haemolytic anaemia
  • Rheumatoid arthritis (RA)
  • Felty syndrome
  • Systemic lupus erythematosus
  • Sarcoidosis
  • Malaria
  • Epstein-Barr virus (EBV)
  • Endocarditis
  • Sepsis-related splenic abscesses
  • Chronic hepatitis C
  • Chronic hepatitis B
  • Sickle cell anaemia
  • Cytoskeletal defects
  • Thalassaemias
Full details

Uncommon

  • Benign splenic tumours
  • Portal vein thrombosis
  • Splenic vein thrombosis
  • Budd-Chiari syndrome
  • Haemophagocytic lymphohistiocytosis (HLH)
  • Amyloidosis
  • Gaucher's or Niemann-Pick disease
  • Severe dengue
  • Splenic rupture
  • Subcapsular haemorrhage
  • Secondary to granulocyte colony-stimulating factor (G-CSF)
Full details

Contributors

Authors

Terri L. Parker, MD

Assistant Professor of Medicine

Section of Hematology

Yale School of Medicine

Smilow Cancer Center at Yale-New Haven

New Haven

CT

Disclosures

TLP declares that she has no competing interests.

Acknowledgements

Dr Terri L. Parker would like to gratefully acknowledge Dr Alan E. Lichtin, the previous contributor to this monograph.

Disclosures

AEL has received research support from Amgen.

Peer reviewers

Priyanka Mehta, MD

Consultant Haematologist

Bristol Haematology and Oncology Centre

Bristol

UK

Disclosures

PM declares that she has no competing interests.

Ruben A. Mesa, MD

Professor of Medicine

Mayo Clinic

Scottsdale

AZ

Disclosures

RAM declares that he has no competing interests.

Giovanni Barosi, MD

Director of the Laboratory of Clinical Epidemiology

IRCCS Policlinico S. Matteo Foundation

Pavia

Italy

Disclosures

GB declares that he has no competing interests.

References

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

Key articles

Gertz MA. Waldenström macroglobulinemia: 2023 update on diagnosis, risk stratification, and management. Am J Hematol. 2023 Feb;98(2):348-58.Full text  Abstract

Alaggio R, Amador C, Anagnostopoulos I, et al. The 5th edition of the World Health Organization classification of haematolymphoid tumours: lymphoid neoplasms. Leukemia. 2022 Jul;36(7):1720-48.Full text  Abstract

Shakoory B, Geerlinks A, Wilejto M, et al. The 2022 EULAR/ACR points to consider at the early stages of diagnosis and management of suspected haemophagocytic lymphohistiocytosis/macrophage activation syndrome (HLH/MAS). Ann Rheum Dis. 2023 Oct;82(10):1271-85.Full text  Abstract

Kowdley KV, Brown KE, Ahn J, et al. ACG clinical guideline: hereditary hemochromatosis. Am J Gastroenterol. 2019 Aug;114(8):1202-18.Full text  Abstract

Reference articles

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
  • Assessment of splenomegaly images
  • Guidelines

    • Haematolymphoid tumours: WHO classification of tumours, 5th edition, volume 11
    • Points to consider at the early stages of diagnosis and management of suspected haemophagocytic lymphohistiocytosis/macrophage activation syndrome (HLH/MAS)
    More Guidelines
  • Patient information

    Hepatitis B: should I have the vaccine?

    Hepatitis C: what is it?

    More Patient information
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