Esplenomegalia: fisiopatologia e propedêutica

Abstract

Splenomegaly is the term given to the condition by which the spleen has an enlargedvolume. It may be caused by various diseases or may be present even in the absence of disease. Forthe diagnosis of the cause of splenomegaly, clinical history and findings on physical orcomplementary examination are useful, potentially even including more invasive diagnosticprocedures like biopsy or diagnostic splenectomy. It is interesting for organized clinical reasoningto consider the three major physiopathologic processes responsible. The first is splenic hyperplasia,which may be secondary to hemolysis, immunologic stimuli, or the need for extramedullaryhematopoiesis. The second is obstruction to portal system flow, whose great representative iscirrhosis. Lastly, the third is infiltrative diseases, both by cells like in hematologic ornonhematologic neoplasms and by certain substances like in amyloidosis.