Hello. Thank you for your question.
It is not uncommon for patients to have splenomegaly (enlarged spleen) with no prior diagnosed or evident condition. This problem is evaluated with a good history (including travel history, prior malignancy (cancer)), physical exam, complete blood count (CBC), liver function tests, urinalysis, and chest x-ray. It sounds as if this has been done already.
You can also ask your physician to test you for HIV.
You should also ask your physician for a consultation to a hematologist. In some cases a diagnostic biopsy of the spleen is also performed if a diagnosis can't be made. Along those lines, splenectomy (removal of the spleen) may be considered, with the value of making a diagnosis balanced against the dangers of the surgery and the complications of living without a spleen (infection, etc). In cases where splenectomy is performed,
the removed spleen may reveal a localized splenic tumor, cyst(s), inflammatory pseudotumor, hamartoma, amyloid, vascular anomaly, infection, sarcoidosis, or other rare condition.
Very Respectfully,
Dr. S
What prompted the CT scan? Sometimes people have big organs. The "normals" are relative but exceptions can occur in perfectly healthy people which is why diagnosis are made in concert with full clinical picture.
Regarding the protein level. .4 is insignificant and likely simply related to fluid intake prior to the blood draw if all of the other labs on liver, CBC etc came back fine.
So what prompted the CT scan?
CT scan was brought on due to me having lower left abdomen pains right under my rib cage that sometimes radiates to my back. They thought it could be kidney stones but no signs of them. Only thing was the enlarged spleen.
Ok well in that case you have symptomology in addition to the clinical sign and it warrants further investigation if you are continuing to have pain there .
Do you know what exact blood work was done and do you have a copy? Knowing what was done and having a copy will help navigate you to additional possibilities to check for if your symptom of pain is persistent.
Not sure of exact tests that were done but know they checked for mono and other diseases, viruses, infections that are related to enlarged spleen. How long am I looking at having this pain and what can I take to make it go down?
I also have pain in my left arm. Is that a typical symptom of an enlarged spleen?
Well, it doesn't sound like an accurate diagnosis has been made yet and I think you need to be more aggressive about pursuing root cause for the pain especially since you report your spleen to be enlarged in addition to that pain. The pain in your left arm can be related to cardiac or vascular issues or possibly nerve compression if there is claudication.
I would recommend that you request copies of your labs, your radiology report, a copy of the DVD of your radiology films and get a second opinion.
Your physician should not have left you in pain without answers or clear diagnosis and treatment plan
Dr Sclafani's Thank you for mentioning the specialist that would deal with this kind of thing. I was unsure about that.
codyjam3s if you have a PPO you won't require referral from your PCP for a hematologist but having a referral can oftentimes get you in sooner. Get those labs/CD of your CT etc so that you can hand it to the hematologist when you visit.
Do you by any chance have morning joint pain stiffness or swelling?