What conditions could lead to the enlargement of the spleen?

Question

Hello doctor,

I have enlarged spleen for the last two years. I am 24 years old, male. My spleen size went from 5.28 inches two years back to 5.5 to 5.6 inches four months back. My CBC report looks normal and I have a vitamin B12 level of 349 and a vitamin D of 11.13. I have MCV level 102.4 and MCH level 34.2.

Monocytes are 0.13 absolute. Can you please guide me on what needs to be done? I had peripheral blood smear, malaria, and hepatitis tests too. All were under limits, as of now I do not have pain. Other doctors suggested a hematologist.

Please help.

Answer 1

Hello,

Welcome to icliniq.com.

I have reviewed your query and below is my opinion.

The various causes for enlarged spleen include infection like malaria, Gaucher disease like storage disorder, hemolytic anemia, leukemia, lymphoma, infections, liver disease, etc. The CBC (complete blood count) and peripheral smear examination report do not suggest leukemia.

Hemolytic anemia also can be excluded as the bilirubin level is normal. Liver disease chance is also very less as reports are normally related to that (attachment removed to protect patient identity). As you have persistent spleen enlargement, it is advisable to investigate with a spleen biopsy or FNAC (fine needle aspiration cytology) for a histopathology examination. It will help in identifying the underlying specific cause if present.

You can consult a surgeon for a detailed evaluation and examination. Then, if needed, the surgeon will suggest you visit a hematologist.

Thank you.

Answer 2

Hello,

Welcome back to icliniq.com.

Your splenomegaly can be graded as mild to moderate. So it cannot be considered an emergency. But you should get it evaluated by the doctor as advised.

Thank you.