Pozo Anna L, Godfrey Edmund M, Bowles Kristian M
Norfolk and Norwich University Hospital, Norwich, United Kingdom.
Blood Rev. 2009 May;23(3):105-11. doi: 10.1016/j.blre.2008.10.001. Epub 2008 Dec 4.
Splenomegaly is a feature of a broad range of diseases, and presents to clinicians in many fields. This review examines the aetiology of splenomegaly in the developed world, and describes a logical approach to the patient with splenomegaly. In some patients, extensive radiological and laboratory investigations will fail to yield a diagnosis: these cases of "isolated" splenomegaly are not uncommon and can be particularly challenging to manage. The risks of serious underlying disease must be balanced against the risks of invasive investigations such as splenic biopsy and diagnostic splenectomy. We discuss the options in isolated splenomegaly and their evidence base, and incorporate them into a management strategy to aid the clinician in cases of diagnostic difficulty.
脾肿大是多种疾病的一个特征，在许多领域的临床医生中都有出现。本综述探讨了发达国家脾肿大的病因，并描述了针对脾肿大患者的合理处理方法。在一些患者中，广泛的影像学和实验室检查未能得出诊断：这些“孤立性”脾肿大病例并不少见，管理起来可能特别具有挑战性。必须在严重潜在疾病的风险与脾穿刺活检和诊断性脾切除术等侵入性检查的风险之间进行权衡。我们讨论了孤立性脾肿大的处理选项及其证据基础，并将其纳入一种管理策略，以帮助临床医生处理诊断困难的病例。
