Multiple Causes Leading to Massive Splenomegaly in an Elderly Female

Abstract

Splenomegaly is defined as enlargement of the spleen measured by size or weight. The spleen is an essential site for
hematopoiesis and immunosurveillance. Splenomegaly may be diagnosed clinically or radiographically using ultrasound,
CT imaging or MRI. Splenomegaly may be a transient condition or may be due to serious underlying acute or chronic
condition. A combination of clinical examination, serology and imaging may diagnose splenomegaly and the underlying
cause. Derangement in the complete blood (cell) counts and morphology including WBC, RBC and platelets will vary based
on underlying disease. Abnormalities in liver function tests, lipase, rheumatologic panels and disease-specific infectious
testing help in ascertaining the cause of splenomegaly. We present here a rare case of massive splenomegaly which had
multiple causes within the same patient contributing to a massive spleen and a diagnostic enigma.