Indications directory

Enlargement due to increased functional activity of the spleen.

Hyperplasia of the RES-system (for disposal of damaged erythrocytes)

Differential diagnosis: Spherocytosis, hemoglobinopathy, paroxysmal nightly hemoglobinuria

Evaluation: Hemolysis signs: Haptoglobin, reticulocytes, LDH, bilirubin

Immune hyperplasia:

Differential diagnosis: Infectious mononucleosis, HIV-infection, hepatitis B, hepatitis C, CMV, subacute endocarditis, connatal lues, tuberculosis, spleen abscess, malaria, leishmaniosis, trypanosomiasis

Evaluation:

Infectious serology or bacteriological cultures

Differential diagnosis: Rheumatoid arthritis (Felty’s syndrome), SLE, vasculitides, immune hemolytic anemia, immune thrombocytopenia, medication reaction, sarcoidosis

Evaluation:

ANA, RF, ANCA, direct and indirect Coombs-test, thrombocyte antibodies and others

Extra-medullary hematopoiesis:

Differential diagnosis: Myelofibrosis, bone marrow damage, bone marrow infiltration caused by leukemia, tumor, M. Gaucher

Evaluation:

Blood count, bone marrow cytology and histology

Enlargement due to decreased blood drain from spleen and portal vein system.

Cirrhosis, congestive heart failure, portal vein obstruction, portal hypertension, hepatic vein obstruction, splenic vein obstruction, aneurysm of the splenic arteria, schistosomiasis, echinococcosis of the liver.

Infiltration of the spleen:

Intracellular or extracellular deposition:

Amyloidosis, M. Gaucher, Niemann-Pick-disease, mucopolysaccharidosis and others

Benign and malignant cellular infiltration:

Leukemia (ALL, CML, CLL and others), lymphomas, M. Hodgkin, myeloproliferative illnesses, polycythemia vera, metastatic tumors (most commonly melanoma) and others Unknown etiology!