What are the symptoms of splenomegaly?

The symptoms of splenomegaly are actually affected by the severity of the disease. Generally, in mild cases, the lower edge of the spleen is 2 to 3 cm below the rib margin, which is mild splenomegaly. In severe cases, some patients may also develop anemia, bleeding, and symptoms of enlarged liver and lymph nodes.

1. The degree of spleen enlargement

(1) Mild splenomegaly: When taking a deep breath, the lower edge of the spleen is 2 to 3 cm below the costal margin, which is mild splenomegaly. It can be seen in certain viral infections, bacterial infections, rickettsial infections, early schistosomiasis, congestive heart failure, portal hypertension in cirrhosis, Hodgkin's disease, juvenile rheumatoid arthritis, systemic lupus erythematosus, tropical eosinophilia, idiopathic thrombocytopenic purpura, etc.

(2) Moderate splenomegaly: The lower edge extends 3 cm below the costal margin to the level of the navel, which is moderate enlargement. It can be seen in acute myeloid leukemia, acute lymphocytic leukemia, chronic hemolytic anemia, infectious mononucleosis, vitamin D deficiency, splenic amyloidosis, malignant lymphoma, Niemann-Pick disease, etc.

(3) Extreme splenomegaly: When the lower edge extends beyond the level of the umbilicus, it is called extreme splenomegaly or giant spleen. It can be seen in chronic myeloid leukemia, chronic malaria, late-stage schistosomiasis, banthalamosis, myelofibrosis, polycythemia vera, thalassemia, Gaucher disease, etc.

2. Quality of the spleen

The quality of splenomegaly caused by different causes may vary to varying degrees. Generally, spleen enlargement caused by acute infection is soft in texture; spleen enlargement caused by chronic infection, leukemia cells, and tumor cell infiltration is hard in texture and has an uneven surface; the spleen of cirrhosis is of medium hardness; the texture of congestive splenomegaly varies depending on the degree of congestion and the duration of congestion. If the duration is short, the congestion is mild and the texture is soft; if the duration is long or the congestion is severe, the texture is hard, but generally there is a feeling of fullness. Cystic swellings have a cystic feel and an uneven surface. It must be pointed out that the degree and quality of splenomegaly vary not only with different causes, but also with different course of disease, treatment conditions and individual responsiveness. These factors should be taken into account when making judgments.

3. Associated signs In addition to splenomegaly caused by various causes, there are also different associated signs.

(1) Anemia, bleeding spots or ecchymoses: seen in hematologic splenomegaly, such as various types of leukemia, idiopathic thrombocytopenic purpura, etc.

(2) Anemia and jaundice: seen in hemolytic anemia, chronic viral hepatitis, cirrhosis, malignant histiocytosis, sepsis, etc.

(3) Enlarged liver and lymph nodes: seen in malignant lymphoma, lymphocytic leukemia, connective tissue disease, infectious mononucleosis, sarcoidosis and certain infectious diseases.