I recently had a visit to a new MPN specialist after mine changed hospitals. I was discussing my diagnosis of pre-MF and why that diagnosis versus ET. One interesting thing that came up was spleen length.
In my ultrasound and other tests my spleen came back as "mildly enlarged" measuring 13.2 cm in length. My new specialist looked at me and said "no that's normal for someone your height". This was news to me. In my case, apparently being a 6'5" (195.6cm) male, normal is anything up to 14.3 cm. If you're curious to see what's considered normal for your height, I found this: qxmd.com/calculate/calculat.... On the page is a link to a research paper as well.
As the only things pointing to pre-MF for me were JAK2, high platelets (500ish), mild splenomegaly (now normal), and a BMB reticulin stain showing MF-1 level of fibrosis, a new pathologist is going to have a look at the BMB slides to see if they agree with MF-1.
My treatment doesn't really change regardless as I have few symptoms and only take aspirin for now, but it is interesting to note for long-term treatment and prognosis.
Interested to hear if others have similar experiences re: spleen size or contradictory information to what I stated above.
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BlastedKnees
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I too had an ultrasound done by my GP which said my spleen was 13cm which on the report was not flagged as being enlarged.
The haematology doctor I first saw said that I had an enlarged spleen from looking at the said report 🤔
Anyway I queried this with my consultant as a worry at my appointment a week later and he looked at the report, then at me and said that for my height that could just be it’s normal size. He did not seem at all concerned at the size.
I also recently had another consultant appointment when I asked how often they do an ultrasound to look at the spleen and she examined me and said it was not palpable but the first doctor said it was 🤷♀️
The info about the relationship between spleen size is correct. The normal range can vary height, age and gender. That is why a nuanced view is important. Mild splenomegaly is quite common with MPNs and is not a big deal provided it stays in the mild range.
Thanks for the reference, it's helpful. I just checked my two ultra sounds, showing 10.2 and 10.3 cm. I didn't get a volume. On the calculator it says 12.9 for a 5'7" guy. So in my case some room to grow. Doesn't hurt having a bit of room, my scans have quantified my Pectus excavatum (smashed chest), upper end of "mild deformity". Stuff gets crowded in there.
In this reference, there is allowance for age, but there is no allowance for height.
They say a normal spleen "...shrinks in older age"
I can relate to the terms they use for various results, in my case it's "hypercellular" in the BMB. It's not really so hyper from my research, but each lab/Dr seems to have different qualitative descriptions as you found.
Hey! I'm sorry to ask here but if you don't mind. But is 10.3 spleen size supposed to be a problem? We often don't get volume estimate and now I'm having a small sharp pain that is gone after 5 seconds. My spleen size in 2022 is 10 cms
Hi Xuzy, you can calculate the upper limit of normal spleen size, based on your sex and height, using the link I posted (qxmd.com/calculate/calculat.... As an example, if you're a 165cm woman the upper range of normal is 12.2cm. The size calculation is just to help gauge what "normal" is, as it related to MPN criteria for diagnosis purposes.
I would talk to your doctor if you're having pains in that area to get a better idea what's going on.
My Dr has not been concerned on the low range size. I also get brief pains there and in my case it seems to be gas according to my Dr. But of course gas is not the only possibility.
If the spleen gets large enough it can be felt for some people even by self inspection, I can't help checking when I get pain.
Hi, my spleen has measured 14 cm for the last 6 years at least, been checked several times by CT or ultrasound. In 2004 during a MRI for back problems it measured 15 cm. I was diagnosed with mpn in 2018. I had a CT 35 years ago for pain in ULQ which the internist said was due to spleen, I don't remember that measurement. My MPN specialist said size of spleen can vary with body size. Thanks for the post.
it’s funny. I’ve had my spleen checked a number of times by different doctors. Most say it’s normal but on one of those tests, it was “mildly enlarged” at 13.2. I’m 5’7”. I get occasional pain there too but I’m never sure what it is. My hematologist doesn’t think it’s my spleen.
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