Splenomegaly: Difference between revisions

Latest revision as of 15:32, 30 July 2020

Background

Hypersplenism is defined as splenomegaly with any of: anemia, leukopenia, or thrombocytopenia, which are expected to correct after splenectomy
- All patients with hypersplenism have splenomegaly, but not all patients with splenomegaly have hypersplenism
- Mostly secondary to other process, but rarely can be primary

Differential Diagnosis

See also massive splenomegaly
Infectious
- Acute
  - Viral: viral hepatitis, infectious mononucleosis, CMV
  - Bacterial: sepsis, salmonellosis, brucellosis, splenic abscess
  - Parasite: toxoplasmosis
- Subacute or chronic
  - Subacute bacterial endocarditis
  - Tuberculosis
  - Malaria
  - Visceral leishmaniasis
  - Fungal infections
Inflammatory
Congestive
- Intrahepatic: cirrhosis
- Extrahepatic:
- Heart failure
Hematologic
- RBC disorders
- Neoplasia
  - Malignant
  - Benign
Genetic/metabolic
- Gaucher disease
- Niemann-Pick disease
Other
- Amyloidosis
- Splenic cyst

@@ Line 1: / Line 1: @@
+==Background==
-== Differential Diagnosis ==
+*'''Hypersplenism''' is defined as splenomegaly with any of: anemia, leukopenia, or thrombocytopenia, which are expected to correct after splenectomy
-* See also [[massive splenomegaly]]
+**All patients with hypersplenism have splenomegaly, but not all patients with splenomegaly have hypersplenism
-* Infectious
+**Mostly secondary to other process, but rarely can be primary
-** Acute
-*** Viral: [[viral hepatitis]], [[infectious mononucleosis]], [[CMV]]
+==Differential Diagnosis==
-*** Bacterial: [[sepsis]], [[salmonellosis]], [[brucellosis]], [[splenic abscess]]
-*** Parasite: [[toxoplasmosis]]
+*See also [[massive splenomegaly]]
-** Subacute or chronic
+*Infectious
-*** Subacute bacterial endocarditis
+**Acute
-*** Tuberculosis
+***Viral: [[viral hepatitis]], [[infectious mononucleosis]], [[CMV]]
-*** Malaria
+***Bacterial: [[sepsis]], [[salmonellosis]], [[brucellosis]], [[splenic abscess]]
-*** Visceral leishmaniasis
+***Parasite: [[toxoplasmosis]]
-*** Fungal infections
+**Subacute or chronic
-* Inflammatory
+***[[Subacute bacterial endocarditis]]
-** [[Felty syndrome]]
+***[[Tuberculosis]]
-** [[Systemic lupus erythematosus]]
-** [[Serum sickness]]
+***[[Malaria]]
-** [[Rheumatic fever]]
+***[[Visceral leishmaniasis]]
+***Fungal infections
-** [[Sarcoidosis]]
+*Inflammatory
-** [[Antiphospholipid antibody syndrome]]
+**[[Felty syndrome]]
-* Congestive
+**[[Systemic lupus erythematosus]]
-** Intrahepatic: [[cirrhosis]]
+**[[Serum sickness]]
-** Extrahepatic:
-*** [[Portal vein thrombosis]]
+**[[Rheumatic fever]]
+**[[Sarcoidosis]]
-*** [[Splenic vein obstruction]]
-*** [[Budd-Chiari syndrome]]
+**[[Antiphospholipid antibody syndrome]]
+*Congestive
-** [[Heart failure]]
+**Intrahepatic: [[cirrhosis]]
-* Hematologic
+**Extrahepatic:
-** RBC disorders
-*** [[Hemolytic anemia]]
+***[[Portal vein thrombosis]]
-*** [[Thalassemia]]
+***[[Splenic vein obstruction]]
-*** [[Sickle cell disease]]
+***[[Budd-Chiari syndrome]]
+**[[Heart failure]]
-** Neoplasia
+*Hematologic
-*** Malignant
+**RBC disorders
-**** [[Myeloproliferative disorder]]
-**** [[Myeloid metaplasia]]
+***[[Hemolytic anemia]]
-**** [[Polycythemia rubra vera]]
+***[[Thalassemia]]
-**** [[Essential thrombocythemia]]
+***[[Sickle cell disease]]
+**Neoplasia
-**** [[Chronic leukemia]]
+***Malignant
-**** [[Chronic myeloid leukemia]]
-**** [[Chronic lymphocytic leukemia]]
+****[[Myeloproliferative disorder]]
-**** [[Hairy cell leukemia]]
+****[[Myeloid metaplasia]]
-**** [[Lymphoma]]
+****[[Polycythemia rubra vera]]
-**** [[Acute leukemia]]
+****[[Essential thrombocythemia]]
-**** [[Malignant histiocytosis]]
+****[[Chronic leukemia]]
+****[[Chronic myeloid leukemia]]
-*** Benign
-**** [[Hamartoma]]
+****[[Chronic lymphocytic leukemia]]
-**** [[Hemangioma]]
+****[[Hairy cell leukemia]]
-**** [[Lymphangioma]]
+****[[Lymphoma]]
-**** [[Fibroma]]
+****[[Acute leukemia]]
+****[[Malignant histiocytosis]]
-* Genetic/metabolic
+***Benign
-** [[Gaucher disease]]
-** [[Niemann-Pick disease]]
+****[[Hamartoma]]
+****[[Hemangioma]]
-* Other
-** [[Amyloidosis]]
+****[[Lymphangioma]]
+****[[Fibroma]]
-** Splenic cyst
+*Genetic/metabolic
+**[[Gaucher disease]]
+**[[Niemann-Pick disease]]
+*Other
+**[[Amyloidosis]]
+**Splenic cyst
 [[Category:Hematology]]