Mild Splenomegaly

[ejg3952]

In May of this year I had an ultrasound for gallstones and the only thing found was a mildly enlarged spleen measuring 13.3cm.  My CBC with differential has been normal 3 times over the last six months.  I decided to have another ultrasound to see if there was any changes to the spleen size and to my surprise it measured 13.7 cm this time.  My doctor did another CBC with differential and liver panel which all came back normal.  He was not concerned about the slight change because he said the spleen can fluctuate a little bit from day to day.  I forgot to mention that I had a chest, abdominal, and pelvic CT scan with contrast in July and everything came back normal.

He told me that he isn't concerned because I don't have chronic infections, fatigue, night sweats etc...

He also said he has never seen a leukemia case begin on the spleen before it showed up on the bloodwork.

He told me 13.7 spleen isn't really that big and shouldn't be of any concern to me and that we will look at it again in a year unless I begin to have symptoms.

I have always trusted him and he is a very qualified doctor who graduated from Harvard Med School.

Would Leukemia show up on the bloodwork?

My platelet count has always been on the low end of normal.  160 to 190


What is your opinion on the last three paragraphs.

THanks,

Joe

[Kevin Pho, MD]

A good proportion of leukemia cases would have abnormalities in the blood count.  A more definitive diagnosis can be obtained by looking at the blood smear or a bone marrow biopsy.

Less than 13cm on ultrasound is considered to be normal for the size of the spleen.  

If the evaluation continues to be negative, serial monitoring can be considered to ensure there is no further growth.

These options can be discussed with your personal physician.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
kevinmd_

[Kalio1]

Has your doctor done a screening for hepatitis b and c? I'd be sure and be tested for them, the ONLY way to verify you aren't positive for them is to do a specific test for it. It can "fly under the radar" meaning you can show few or no clues in your bloodwork, my liver panels came back "normal" too, which is one reason it wasn't diagnosed and why they didn't test me for it.

My spleen measures the same as yours, it was caused by hep c I had and was totally unaware of. The doctors misdiagnossed it because I did not fit the "profile" of a hep c patient. Apparently I picked it up somewhere along the line, but since I had no history of drug abuse or transfusions they didn't test for it. Be tested to rule it out because or if you do have it, it could explain why your spleen is enlarged.

They do not always test for it unfortunately. I had hepatic panels done and hep c was NOT tested for I found out much later on. Ask the doctor if he tested for hep c or if he is just going by your other bloodwork results. Some of us do not get "clues" like elevated ALT/AST readings to clue the doctor that we have it.

[bjg05044]

Thanks for the insight about Hep C.

I wasted $15 to the doctor.  I could have gotten his answer off the internet.  I was expecting his opionion of the situation rather than some verbatim out of a medical book. He never even answered one question.  I dissapointed to say the least by the response but at least the $15 goes to a good cause.

The neurological site is excellent but obviously has different doctors answering the questions.

[wking]

A related discussion, enlarged spleen was started.