Splenomegaly

History: 50 year old female with abdominal swelling and pain. 

Splenomegaly: Coronal CT of the abdomen and pelvis with IV contrast reveals a massively enlarged spleen.

This is the appearance of splenomegaly on CT. The normal spleen measures less than 13 cm in length. The differential diagnosis for splenomegaly is usually divided into blood flow problems (AKA: hemodynamics) such as congestive heart failure and portal hypertension, hematologic conditions such as polycythemia vera or when extramedullary hematopoesis is occuring, infectious causes such as infectious mononucleosis, and infiltrative disorders such as amyloidosis. This was a case of polycythemia vera.