Splenomegalie

Coronar
reformatierte Computertomographie einer Patientin mit chronisch lymphatischer Leukämie (CLL). Deutliche Splenomegalie.
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Primary
myelofibrosis: spectrum of imaging features and disease-related complications. Portovenous phase axial (a) and coronal (b) CT of the abdomen in two different patients with myelofibrosis demonstrating osteosclerosis and massive splenomegaly. Note the presence of splenic varices and cavernous transformation of the portal vein on the axial image (a). Periportal low attenuation is also seen, consistent with periportal oedema and in keeping with portal hypertension. On the coronal image, linear low attenuation at the inferior aspect of the spleen is consistent with splenic infarction, another complication of massive splenomegaly
insightsimaging.springeropen.com • CC-by-4.0
Primary
myelofibrosis: spectrum of imaging features and disease-related complications. Coronal CT of the abdomen demonstrating a markedly enlarged spleen (asterisk). The combination of osteosclerosis and massive splenomegaly has a narrow differential diagnosis and is most suggestive of myelofibrosis
insightsimaging.springeropen.com • CC-by-4.0
School ager
with hypersplenism. AP image from a splenic angiogram (left) shows an extremely enlarged spleen. AP image from a splenic angiogram obtained after embolization with polyvinyl alcohol 250 to 350 micron particles (right) shows the spleen to be reduced in size by 75%.The diagnosis was splenomegaly treated with partial splenectomy via embolization.
pediatricimaging.org • CC-by-nc-sa 4.0
Radiopaedia • CC-by-nc-sa 3.0 • de

Splenomegaly refers to enlargement of the spleen. The upper limit of normal adult splenic length is traditionally cited at 12 cm, but lengths upwards of 14 cm can be seen in normal, taller males .

Massive splenomegaly is variably defined, including when the spleen is 5 standard deviations above the mean normal volume (about 943 cm) , heavier than 1000 g  or 1500 g ,longer than 18 cm , or extending into the pelvis or across midline .

Pathology

The causes of splenomegaly are protean, and can be thought of under a number of headings :

  • hematological disease
  • hemodynamic
  • infectious
  • storage diseases/metabolic/infiltrative disorders
  • neoplastic (non-hematologic)
  • traumatic
  • connective tissue disorders
Hematological disease
Hemodynamic
Infection
Storage diseases/metabolic/infiltrative disorders
Neoplastic (non-hematologic)
Trauma
Connective tissue disorders

* may cause massive splenomegaly

Radiographic features

The shape and orientation of a spleen make accurate linear measurement difficult.

On CT, a splenic width measurement (largest anterior-posterior measurement on axial images) of greater than 10.5 cm is the most accurate single measurement for mild to moderate splenomegaly in patients with cirrhosis; while a craniocaudal measurement of greater than 14.6 cm is the most accurate single measurement for massive splenomegaly .

On sonographic assessment, a length of 12 cm is generally considered the upper limit of normal.

See also

Siehe auch:
und weiter:
Assoziationen und Differentialdiagnosen zu Splenomegalie:
Tuberkulose
 
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Mukopolysaccharidose
 
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Thalassämie
 
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Echinokokkose
 
www.eurorad.org • CC by-nc-sa-4.0
Sarkoidose
 
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Osteopetrose
 
ojrd.biomedcentral.com • CC-by-2.0
portale
Hypertension
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Osteomyelofibrose
 
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Sichelzellenanämie
 
pediatricimaging.org • CC-by-nc-sa 4.0
extramedulläre
Hämatopoese
www.eurorad.org • CC by-nc-sa-4.0
Hämangiom
 
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Leberzirrhose
 
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lymphatische
Malformationen
pediatricimaging.org • CC-by-nc-sa 4.0