From the Guidelines
The normal spleen size is typically considered to be less than 13 cm in vertical length, as defined by the Lugano Criteria. This definition is based on the international working group consensus response evaluation criteria in lymphoma (RECIL 2017) 1. The spleen size can vary considerably in healthy individuals, and it is not usually selected as a target lesion. To measure the spleen size, the vertical length should be carried out in the coronal image, or alternatively, the spleen vertical length can be calculated by multiplying the number of spleen slices in transverse CT views by the thickness of each slice, or by measuring splenic coronal diameter on a PET maximum intensity projection image 1. Some key points to consider when evaluating spleen size include:
- The plane of measurement, which should be the coronal image
- The method of measurement, which can be direct or calculated
- The threshold for splenomegaly, which is greater than 13 cm in vertical length It is essential to note that the spleen's size and shape can vary significantly among healthy individuals, and the definition of normal spleen size may depend on the specific context and population being studied 1.
From the Research
Normal Spleen Size
- The normal size of the adult spleen can vary depending on several factors, including age, sex, and body parameters 2.
- A study conducted on 300 healthy adult volunteers found that the mean spleen length, thickness, width, and volume were 10.68±1.28 cm, 4.1±0.58 cm, 7.3±0.9 cm, and 174.4±52.4 ml, respectively 2.
- Males were found to have larger spleen parameters than females, and spleen volume was significantly correlated with height and weight 2.
- Another study established height- and sex-corrected normal values for spleen length and volume, and found that spleen length and volume were significantly and independently associated with sex, body height, and weight 3.
Factors Influencing Spleen Size
- Body height and sex are significant factors that influence spleen size, with taller and heavier individuals having longer and larger spleens 3.
- Age is also a factor, although the correlation between age and spleen volume is weaker than that between height and weight 2.
- Body mass index (BMI) is also correlated with spleen volume, although the correlation is weaker than that between height and weight 2.
Clinical Significance
- Splenomegaly, or enlargement of the spleen, can be a sign of a systemic condition, and diagnosis and management involve treating the underlying disease process 4.
- Splenomegaly can be caused by various mechanisms, including liver disease, malignancy, and infection, and symptoms can suggest the underlying cause 4.
- Abnormal spleen size can also be associated with coagulation abnormalities and hypersplenism, particularly in patients with liver disease 5.