Table of Contents
Hepatomegaly
- Malignancy
- Primary or secondary
- Hepatic congestion
- Right heart failure
- Hepatic vein thrombosis (Budd-Chiari syndrome)
- Haematological
- Lymphoma/leukaemia/myeloproliferative
- Infection
- Infectious mononucleosis
- Viral hepatitis
- Anatomical
- Riedel’s lobe
- Other
- Non-alcoholic fatty liver disease
- Alcoholic liver disease
- Sarcoidosis
- Amyloidosis
- Infective endocarditis
NB: the liver is often not palpable in cirrhosis because it shrinks. Splenomegaly due to portal hypertension is a more common finding.
Splenomegaly
- Infiltration
- Leukaemia
- Lymphoma
- Myeloproliferative disorders
- Increased function
- ↑Extravascular haemolysis (haemoglobinopathy, thalassaemia, spherocytosis)
- ↑Extramedullary haematopoiesis (myelofibrosis, malignant bone marrow infiltration)
- ↑Response to infection (HIV/AIDS, glandular fever, infective endocarditis, malaria, autoimmune disorders)
- Vascular congestion
- Cirrhosis (causing portal hypertension)
- Splenic vein obstruction
- Budd-Chiari syndrome
NB: Massive splenomegaly is usually due to: chronic Myeloid leukaemia, Myelofibrosis, Malaria (or less commonly splenic lymphoma or visceral leishmaniasis).
Hepatosplenomegaly
- Chronic liver disease with portal hypertension
- Any cause of chronic liver disease
- Haematological
- Leukaemia
- Lymphoma
- Myeloproliferative disorders
- Infections
- Acute viral hepatitis
- CMV/EBV
- Malaria
- Visceral leishmaniasis
- Infiltration
- Amyloidosis
- Sarcoidosis
