Enlarged Spleen (22cm) with cysts and lesions

I am 35, female 115 lbs. I have an enlarged spleen with cysts and lesions. It is also rough as opposed to being smooth. My plateletts are just below normal (128). I have had many tests (CT scans and ultrasounds) that show the enlarged spleen. Everything else is pretty normal. I have the Leiden Factor V blood disorder. I had a HIDA scan that showed my gall bladder worked at 2 percent. My doctor mentioned that it's possible that I could have a primary splenic lymphoma. I am waiting for my bone marrow biopsy results. What are the chances of having a lymphoma that is contained within my spleen? Wouldn't a CBC show something? What would be the procedure for curing the lymphoma if that is the case?
Thank you,
Stacyj

[Kevin Pho, MD]

To answer your questions:
1) Without examination, I cannot give an estimate of what the chances are that lymphoma is causing the spleen to be enlarged.  However, with the imaging tests you have had done (i.e. CT scans and ultrasounds), this possibility may be less likely.  

2) Yes, the CBC (as well as the peripheral smear) is important in the diagnosis of an enlarged spleen.  However, there are some diseases that can present with a normal CBC.  

3) If it is indeed lymphoma, treatment would depend on the size of the cancer as well as whether it has spread.  Without knowing that, it is tough to speculate on the method of treatment.  

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.
Medical Weblog:
kevinmd_b

[surgeon]

CBC wouldn't necessarily show anything. Treatment would be splenectomy, with or without chemotherapy depending on the final details.

[nst0199]

Enlarged Spleen can mean portal Hypertension.  This will enlarge your spleen and will also make your spleen burn up platelets like crazy.  Normal platelets is 140-400.  With out knowing your Past medical history and your normal blood pressure history.  If you have any questions its best to talk with a well known Liver Specialist.

[shoky]

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