What is the average spleen size based on height and sex?

Average Spleen Size Based on Height and Sex

The normal spleen length is ≤13 cm for adults, but this varies significantly by sex and height, with men having spleens approximately 1 cm longer than women, and taller individuals having proportionally larger spleens. 1, 2

Standard Measurement Parameters

• Normal adult spleen length is defined as ≤13 cm when measured in the coronal plane, as established by the American College of Radiology and European Society for Medical Oncology 1
• Measurement should be performed as the vertical length in the coronal plane using CT scan, ultrasound, or PET/CT 1
• The 13 cm threshold represents the upper limit of normal across most clinical contexts 1, 3

Sex-Based Differences

Men have significantly larger spleens than women across all measurements:

• Mean splenic length in men: 11.1 cm (±0.9 SD) 4
• Mean splenic length in women: 10.1 cm (±0.7 SD) 4
• The sex difference is statistically significant (P<0.001) and persists across all dimensions including width, depth, and volume 4
• Men's spleens are approximately 0.5-1.0 cm longer than women's spleens in the same height range 2, 5

Height-Based Variations

Height is the most significant independent predictor of spleen size:

• Spleen length and volume correlate significantly with body height (P<0.001 for both) 2
• Using the traditional 12 cm cutoff, 26% of healthy men exceeded this threshold, indicating the need for height-adjusted norms 2
• Taller individuals have proportionally larger spleens, requiring height-corrected reference values 2
• The correlation between height and spleen size is stronger than the correlation with weight or body mass index 4, 2

Specific Reference Values by Sex and Height

For women (height 155-179 cm):

• Height-corrected normal values are available through validated algorithms 2
• Mean splenic volume: 153.7 cm³ (±33.2 SD) 4

For men (height 165-199 cm):

• Height-corrected normal values are available through validated algorithms 2
• Mean splenic volume: 202.7 cm³ (±49.4 SD) 4

Clinical Grading System

• 11-13 cm: Mild splenomegaly 1, 3
• >13 cm: Clinically significant splenomegaly 1, 3
• This grading system applies regardless of sex or height, though context matters 1

Important Clinical Caveats

Common pitfalls to avoid:

• The traditional 12 cm cutoff is outdated and misclassifies many normal individuals, particularly tall men 2
• Normal spleen size varies considerably based on race, body size, and height 1
• A normal-sized spleen does not exclude splenic pathology such as infiltrative lymphoma 1, 3
• Physical examination alone is unreliable for detecting mild to moderate splenomegaly; imaging is essential 1
• Spleen size remains relatively stable over time in healthy individuals (median difference 0.10 cm on repeat measurements) 2

Practical Application

For accurate assessment, clinicians should:

• Use the 13 cm threshold as the standard upper limit of normal for general screening 1, 3
• Consider sex and height when interpreting borderline measurements (11-13 cm range) 2
• Recognize that spleens measuring 11-13 cm may be normal in tall men but warrant further evaluation in shorter women 1, 2
• Utilize validated height- and sex-corrected algorithms when available for more precise percentile determination 2