Hypersplenism

Stasis/trapping in spleen → Mϕ attack/remodel RBCs → spherocytosis → hemolysis

Causes of Splenomegaly

RES hyperplasia

• Hemolytic anemia, sickle cell disease, thalassemia major

Immune hyperplasia

• Infxn [HIV, EBV, CMV, TB, malaria, kala azar (“black water fever” from visceral leishmaniasis), Mycobacterium avium complex], autoimmune disorders (SLE, RA w/ Felty’s syndrome), sarcoidosis, serum sickness

Congestion

• Cirrhosis,
• CHF,
• portal/splenic vein thrombosis,
• schistosomiasis

Infiltration (nonmalignant)

• Lysosomal storage disorders (Gaucher’s, Niemann-Pick),
• glycogen storage diseases
• histiocytosis X, splenic cysts

Neoplasm

causes of massive splenomegaly.

• MPN (CML, PMF, PV, ET), CMML, leukemia, lymphoma (NHL, HL, hairy cell leukemia, CLL, PLL, WM),

沒那麼嚴重的:

• T-LGL, myeloma, amyloid