The spleen becomes enlarged, particularly with myelofibrosis, in which bone marrow is obliterated and the spleen assumes an increasing hematopoietic function. Finding invasion of bone marrow by lymphoid elements is helpful in diagnosis. In the latter, often termed Felty's syndrome, neutropenia may be severe and associated with frequent infections. Associated bleeding from esophageal varices may be worsened by the superimposed thrombocytopenia induced by splenomegaly. Splenic venography and MRI, which may demonstrate or exclude extrahepatic portal obstruction, aid in diagnosis.
Treatment is determined by the underlying disorder.
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