To answer your questions:
1) It is somewhat puzzling that a nodule was found on ultrasound, but not on MRI. If feasible, discussion of whether a liver biopsy may help can be considered.
2) By ultrasound, a normal spleen should measure < 13cm.
3) The size of the spleen has clearly increased over that time period. I agree with the further imaging studies, and I would consider blood tests like a CBC and peripheral smear to exclude hematologic diseases.
If the spleen continues to enlarge, removing it can be considered.
4) Viral disease can lead to chronic mouth ulcers. I am not aware of a specific disease that connects this symptoms to those of your spleen.
5) With multiple MRIs performed, it's difficult to recommend further imaging scans. Obtaining a hematology evaluation can be considered to explore other causes of the enlarged spleen.
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 Pho, M.D.
KevinMD.com
Twitter.com/kevinmd
I should have added that both of the MRI were with and without contract and neither showed any focal liver mass to corospond to the hypoechoic one on the repeat u/s is this common for the MRI not to detect such things?????
thanks