Tuesday, 3 June 2008

splenomegaly



exam question:
young black man with massive splenomegaly.no lymph nodes.asked for the single most likely diagnosis.

causes for splenomegaly:
1-Neoplastic
Lymphoproliferative: CCL, lymphoma
Myeloproliferative: CML, myelofibrosis
2-Inflammatory
Amyloidosis SLE
Sarcoidosis RA
3-Infective
Glandular fever
Hepatitis
Chronic malria/Brucelosis
SBE
4-Others
PRV cirrhosis
ITP storage disease

in which conditions the spleen is massively enlarged?

another exam question:
large isolated splenomegaly,no anaemia,no lymphadenopathy.
what is the most likely diagnosis?
how would you investigate?

4 comments:

  1. another classification:
    massive spleen:
    CML
    myelofibrosis
    chronic mararia
    kalazar

    moderate spleen(2-4 fingers)
    myeloproliferative disorders
    lymphoproliferative disorders

    just tipped:
    myeloproliferative disorders
    lymphoproliferative disorders
    cirrhosis
    inffection(glandualr fever,hepatitis,SBE

    ReplyDelete
  2. managment of huge splenomegaly

    u/s if malignancy do CT scan
    FBC for hypersplensim, pancytopenia
    blood film for malaria and leshmaniasis and blast cells erythroblastc picture
    bone marrow examination for CML and myelofibrosis
    splenic biopsy if u suspect Guacher's disease

    mgt of moderate spleen
    U/S abdomen
    FBC studies for hypersplensim and atypical lymphocyets fro glandular fever
    bone marrow and lymph node biopsy
    renal and liver function tests
    viral hepatits screen
    Rh factor
    retics and screen for hemolytic anaemias

    ReplyDelete
  3. confirm splenomegaly.
    tell the examiner that you would like to ask about:Wt loss, fever and night sweats.
    look for bone marrow aspiration/ trephine dressing or brusing over the iliac crest.
    tell the examiner you would like to request a prepheral blood film.

    ReplyDelete