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Alternative Names: Splenomegaly.
Spleen enlargement is an enlargement of the spleen beyond its normal size. The spleen is located on the left side of the abdomen and weighs around 200g (8oz) in the average healthy adult. The spleen can be considered a dual-purpose organ: it filters the blood and removes abnormal cells (such as old and defective red blood cells), and it makes disease-fighting components of the immune system (including antibodies and lymphocytes). Since the spleen is involved in so many bodily functions, it is vulnerable to a wide range of disorders involving the blood or lymph system, and by infection, malignancies, liver disease, or parasites.
The body of the spleen appears red and pulpy, surrounded by a tough capsule. The red pulp consists of blood vessels (splenic sinusoids) interwoven with connective tissue (splenic cords). The red pulp filters the blood and removes old and defective blood cells. The white pulp is inside the red pulp, and consists of little lumps of lymphoid tissue. Antibodies are made inside the white pulp. Similar to other organs of the lymphatic system, particular immune cells (B-lymphocytes and T-lymphocytes) and blood cells are either made or matured inside the spleen. Blood enters the spleen via the splenic artery, which subdivides into many tiny branches. Each branch is encased in a clump of lymphocytes, which means every drop of blood is filtered for foreign particles as it enters the spleen.
Hypersplenism is the name given to the condition where the spleen becomes overactive and destroys more blood cells than it should. Symptoms depend on which blood component is lacking. For example, if red blood cells are deficient, anaemia will result (with symptoms including fatigue and pallor). Most cases of hypersplenism are caused by disorders somewhere else in the body, such as cirrhosis of the liver.
Splenic rupture can be caused by certain disorders such as infectious mononucleosis: the spleen becomes delicate enough to spontaneously rupture. A sudden blow to the abdomen can split the outer capsule of the spleen and cause bleeding into the abdominal cavity. There are various degrees of splenic rupture. When bleeding is life-threatening, surgery to remove the spleen (splenectomy) is needed.
Incidence; Causes & Development
Splenomegaly occurs in about 10% of systemic lupus erythematosus patients.
A variety of disorders can cause the spleen to enlarge, sometimes to 2kg (roughly 4lbs) or more. Any condition that causes a rapid breakdown of blood cells, such as haemolytic anaemia, can place great strain on the spleen and make it enlarge. This includes:Signs & Symptoms
Although often there are no symptoms, there may be pain in the left upper section of the abdomen. If this pain is present, especially if it is severe or gets worse when taking a deep breath, then medical attention should be sought immediately. An enlarged spleen may also cause a premature feeling of fullness at meals.
Diagnosis & Tests
Depending on the condition under investigation, disorders of the spleen can be diagnosed using a number of tests, including:- Physical examination. A physician will tap along the left-upper quadrant of the abdomen and feel in that same area, especially just under the rib cage.
- Blood tests such as a CBC
- Ultrasound
- Abdominal film or CT scan
- Bone marrow biopsy
- Other tests to check for underlying disorders.
The physician will also ask a series of questions to determine if there are symptoms either from the enlarged spleen or the underlying cause of the large spleen.
Treatment & Prevention
Appropriate limitation of activity, including avoiding contact sports, will help prevent trauma that might cause the spleen to rupture.
Prognosis; Complications
Care will be required for the specific condition causing the splenomegaly.
Rupture of the enlarged spleen is particularly possible in infectious mononucleosis and several other causes of splenomegaly.
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Enlarged Spleen suggests the following may be present: | | | | | Autoimmune |  Sarcoidosis |
Organ Health |
 Hypersplenism | Hypersplenism is sometimes referred to as enlarged spleen (splenomegaly), but in fact an enlarged spleen is one of the symptoms of hypersplenism. What differentiates hypersplenism is its premature destruction of blood cells. |
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Recommendations and treatments for Enlarged Spleen: | | | | | Surgery/Invasive |  Surgery| | A severely ruptured spleen is usually surgically removed. The human body usually adapts well to life without a spleen, so surgically removing a diseased or damaged spleen is possible without causing serious harm to the patient. In some cases, it is possible to remove only the diseased or damaged parts of the spleen, allowing the remaining healthy portions to keep functioning as normal. |
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KEY | | Weak or unproven link | | | Strong or generally accepted link | | | May do some good |
GLOSSARY
Abdomen (Abdominal)
That part of the body between the chest and the hips that contains the stomach, intestines, liver, bladder, pancreas and other organs.
Anemia (Anaemia, Anemias)
A condition resulting from an unusually low number of red blood cells or too little hemoglobin in the red blood cells. The most common type is iron-deficiency anemia in which the red blood cells are reduced in size and number, and hemoglobin levels are low. Clinical symptoms include shortness of breath, lethargy and heart palpitations.
Antibody (Antibodies)
A type of serum protein (globulin) synthesized by white blood cells of the lymphoid type in response to an antigenic (foreign substance) stimulus. Antibodies are complex substances formed to neutralize or destroy these antigens in the blood. Antibody activity normally fights infection but can be damaging in allergies and a group of diseases that are called autoimmune diseases.
Arterial (Arteries, Artery)
Blood that leaves the heart. When it leaves the right ventricle, it is venous blood; and when it leaves the left ventricle, through the aorta, it is fresh and oxygenated. After it has passed out to the capillaries and started to return, it is venous blood.
Autoimmune Disease (Autoimmune, Autoimmunity)
One of a large group of diseases in which the immune system turns against the body's own cells, tissues and organs, leading to chronic and often deadly conditions. Examples include multiple sclerosis, rheumatoid arthritis, systemic lupus, Bright's disease and diabetes.
Bacteria (Bacterial, Bacterium)
Microscopic germs. Some bacteria are "harmful" and can cause disease, while other "friendly" bacteria protect the body from harmful invading organisms.
Biopsy
Removal of a sample of tissue from a living being for diagnosis. A pathologist later uses a microscope to look for certain features, such as cancer cells, in the sample. A fine-needle aspiration biopsy involves inserting a thin needle to remove a small amount of tissue, sometimes using CT or ultrasound to guide the needle. A core biopsy involves obtaining a sample of tissue with a thick needle or by inserting a thin, lighted tube (laparoscope) into a small incision in the abdomen. Another biopsy method is to remove tissue during an operation.
Cholangitis
Bile duct inflammation.
Cirrhosis (Liver Cirrhosis)
A long-term disease in which the liver becomes covered with fiber-like tissue. This causes the liver tissue to break down and become filled with fat. All functions of the liver then decrease, including the production of glucose, processing drugs and alcohol, and vitamin absorption. Stomach and bowel function, and the making of hormones are also affected.
Complete Blood Count (CBC)
A set of measurements that are generally determined by specially designed machines that analyze the different components of blood in less than a minute. The values generally included are:- White blood cell count (WBC). The number of white blood cells in a volume of blood. Normal range varies slightly between laboratories but is generally between 4,300 and 10,800 cells per cubic millimeter. This can also be referred to as the leukocyte count and can be expressed in international units as 4.3 - 10.8 x 10^9 cells per liter.
- Automated white cell differential. A machine-generated percentage of the different types of white blood cells, usually split into granulocytes, lymphocytes, monocytes, eosinophils, and basophils.
- Red cell count (RBC). The number of red blood cells in a volume of blood. Normal range varies slightly between laboratories but is generally between 4.2 - 5.9 million cells per cubic millimeter. This can also be referred to as the erythrocyte count and can be expressed in international units as 4.2 - 5.9 x 10^12 cells per liter.
- Hemoglobin (Hb). The amount of hemoglobin in a volume of blood. Normal range for hemoglobin is different between the sexes and is approximately 13 - 18 gm/dl for men and 12 - 16 for women (international units 8.1 - 11.2 millimoles/liter for men, 7.4 - 9.9 for women).
- Hematocrit (Hct). The ratio of the volume of red cells to the volume of whole blood. Normal range for hematocrit is different between the sexes and is approximately 45 - 52% for men and 37 - 48% for women.
- Mean cell volume (MCV). The average volume of a red cell. This is a calculated value derived from the hematocrit and red cell count. Normal range is 86 - 98 femtoliters.
- Mean cell hemoglobin (MCH). The average amount of hemoglobin in the average red cell. This is a calculated value derived from the measurement of hemoglobin and the red cell count. Normal range is 27 - 32 picograms.
- Mean cell hemoglobin concentration (MCHC). The average concentration of hemoglobin in a given volume of red cells. This is a calculated volume derived from the hemoglobin measurement and the hematocrit. Normal range is 32 - 36%.
- Red cell distribution width (RDW). A measurement of the variability of red cell size. Higher numbers indicate greater variation in size. Normal range is 11 - 15.
- Platelet count. The number of platelets in a volume blood. Platelets play a vital role in blood clotting. Normal range varies slightly between laboratories but is in the range of 150,000 - 400,000 per cubic millimeter (150 - 400 x 10^9 per liter).
Computerised Tomography (CAT Scan, Computed Tomography, Computerized Axial Tomography, CT Scan)
A scanning procedure using X-rays and a computer to detect abnormalities of the body's organs. This technique provides cross-sectional images of body organs, which is much clearer than those provided by conventional X-rays.
Cystic Fibrosis
(CF) An incurable genetic disease involving a sticky buildup of mucus in the lungs (which makes breathing difficult and leads to infections), as well as pancreatic insufficiency (which leads to digestive problems). Symptoms include chronic cough producing thick mucus, excessive appetite combined with weight loss, intestinal disorders, salty sweat/skin and pneumonia. Lung-related problems are the most frequent cause of death. CF is a recessive disease, occurring only when a person inherits two mutated copies of the CF gene - one from each parent. Individuals with CF generally have a life expectancy of about 30 years.
Cytomegalovirus (CMV)
A member of the herpes virus family which may induce the immune-deficient state or cause active illness, such as pneumonia, in a patient already immune-deficient due to chronic illness, such as cancer or organ transplantation therapy.
Epstein Barr Virus (EBV, Epstein-Barr Virus)
A virus that causes infectious mononucleosis and that is possibly capable of causing other diseases in immunocompromised hosts.
Glandular (Glandulars, Raw Glandulars)
Either referring to a gland, OR glands and organs from animals specially processed at temperatures not exceeding body heat and put into supplement form.
Hemolytic
Promoting the breakdown of red blood cells; a normal process, hectic and skillfully balanced, the term is usually applied to excess conditions or toxic substances that degrade the bonds between healthy red blood cells and their hemoglobin coat or cause the liver and spleen to hypercatabolize otherwise healthy erythrocytes.
Hemolytic Anemia
Anemia caused by excessive destruction of red blood cells.
Hodgkin's Disease (Hodgkin's)
Cancer of the lymphatic system and lymph nodes.
Hypertension
High blood pressure. Hypertension increases the risk of heart attack, stroke, and kidney failure because it adds to the workload of the heart, causing it to enlarge and, over time, to weaken; in addition, it may damage the walls of the arteries.
Idiopathic
Arising spontaneously or from an obscure or unknown cause.
Immune System (Immune Response, Immunity)
A complex that protects the body from disease organisms and other foreign bodies. The system includes the humoral immune response and the cell-mediated response. The immune system also protects the body from invasion by making local barriers and inflammation. The process may involve acquired immunity (the ability to learn and remember a specific infectious agent), or innate immunity (the genetically programmed system of responses that attack, digest, remove, and initiate inflammation and tissue healing).
Kilogram (kg, kgs, Kilogramme, Kilogrammes, Kilograms)
1000 grams, 2.2lbs.
Leukemia
Cancer of the lymph glands and bone marrow resulting in overproduction of white blood cells (related to Hodgkin's disease).
Liver (Hepatic)
The largest and one of the most complex organs of the body, the liver is responsible for much of the metabolism of fats, proteins and carbohydrates. It is the site of much of the body's detoxification. It is connected very closely with digestion and the regulation of blood sugar, among many other functions. Found behind the ribs on the right side of the abdomen, it has many important functions such as removing harmful material from the blood, making enzymes and bile that help digest food, and converting food into substances needed for life and growth. Hepatic: Pertaining to the liver.
Lymph
A clear fluid that flows through lymph vessels and is collected from the tissues throughout the body. Its function is to nourish tissue cells and return waste matter to the bloodstream. The lymph system eventually connects with and adds to venous circulation.
Lymphatic System
A network of vessels which collect fluid from the tissues of the body and return it to the blood. Lymphatic fluid (also called lymph) is rich in white blood cells that fight infection and an important part of the body's immune system.
Lymphoma (Lymphomas)
Any tumor of the lymphatic tissues.
Mononucleosis
Infectious Mononucleosis: An acute, infectious disease caused by the herpes virus or Epstein-Barr virus, with fever and inflamed swelling of the lymph nodes around the neck, under the arms, and in the groin. The general symptoms are fever,
sore throat, exhaustion, and abnormal white blood cells.
Ounce (Ounces, oz)
Approximately 28 grams.
Parasite (Parasites, Parasitic, Parasitical)
An organism living in or on another organism.
Pound (lb, lbs)
454 grams, or about half a kilogram.
Red Blood Cell (Erythrocyte, Erythrocytes, RBC, Red Blood Cells)
Any of the hemoglobin-containing cells that carry oxygen to the tissues and are responsible for the red color of blood.
Spleen (Splenectomy)
The largest organ of the lymphatic system in the body, located between the stomach and the diaphragm (the muscle below the lungs which provides the motion for breathing). It destroys old red blood cells, produces lymphocytes and plasma cells, and stores blood. It also has other as yet unknown functions. A splenectomy is the surgical removal of the spleen.
Splenitis (Splenomegaly)
Inflammation of the spleen, caused by a variety of conditions ranging from exposure to hemolytic chemicals, systemic infections lodged in the spleen, even cancer. Splenomegaly: For practical purposes a term interchangeable with splenitis, since neither will have the usual symptoms associated with inflammation. Splenomegaly is often associated with viral hepatitis, mononucleosis, typhoid fever and abnormally high levels of red blood cells or platelets.
Syndrome
A medical condition characterized by a collection of related symptoms (what the patient feels) and signs (what a doctor can observe or measure).
Thalassemia
An inherited form of anemia occurring chiefly among people of Mediterranean descent, caused by faulty synthesis of part of the hemoglobin molecule.
T-Lymphocyte (T-Lymphocytes)
Long-lived mononuclear white blood cell having the property of destroying target cells and responsible for cell-mediated immunity.
Ultrasound
Ultrasound testing uses sound waves projected into the body to produce an image of internal organs, structures, tumors, etc. In this procedure, a gel is applied to the patient's skin, and a small device that emits ultrasonic pulses is slowly passed over the area. The sonic image produced is viewed on a monitor.
Last updated: Jun 28, 2008
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