hepatosplenomegaly

Hepatosplenomegaly is simply the simultaneous presence of a pathologically-enlarged liver (hepatomegaly) and spleen (splenomegaly).

Pathology

Etiology

Infection

Many, many infections can produce a mild concurrent enlargement of the liver and spleen. This list is by no means exhaustive!

• viral
  • EBV (infectious mononucleosis) (common)
  • AIDS with Mycobacterial avium complex infection*
  • CMV
  • rubella
• bacterial
  • tuberculosis (miliary)
  • subacute bacterial endocarditis
  • typhoid fever
  • brucellosis
  • syphilis
  • abscess
• fungal
  • histoplasmosis
  • candidiasis 
• parasitic disease
  • malaria
  • schistosomiasis
  • hydatid disease
  • leishmaniasis (kala-azar)

Malignancy

• lymphoma
• leukemia 
• multiple metastases: primaries: melanoma, pancreatic, breast, hepatic angiosarcoma
  • splenic metastases not usually seen unless advanced metastatic disease

Hematological

• extramedullary hematopoiesis
• thalassemia
• sickle cell disease: normal/atrophic spleen more common
• systemic mastocytosis
• myelofibrosis
• hemochromatosis
• hemophagocytic lymphohistiocytosis (HLH)

Storage diseases/metabolic/infiltrative disorders

• lysosomal storage disorders 
  • Gaucher disease 
  • mucopolysaccharidoses 
  • Niemann-Pick disease
  • Wolman disease
  • alpha-mannosidosis
• glycogen storage diseases
• porphyria
• amyloidosis
• sarcoidosis
• hypervitaminosis A

Connective tissue disorders

• rheumatoid arthritis
  • Felty syndrome
  • juvenile rheumatoid arthritis (JNR)
  • Still disease
• systemic lupus erythematosus (SLE)

Others

• cirrhosis (early)
• portal hypertension (non-cirrhotic)
• Graves disease 

Siehe auch:

• Splenomegalie
• fetal hepatosplenomegaly

und weiter:

• Beckwith-Wiedemann-Syndrom