Differential Diagnosis for Enlargement of Spleen in a Young Healthy Male
Single Most Likely Diagnosis
- Viral Infectious Mononucleosis (Mono): This is often the most common cause of splenomegaly in young, healthy individuals, typically resulting from Epstein-Barr virus infection. The condition is characterized by fever, sore throat, fatigue, and lymphadenopathy, in addition to splenomegaly.
Other Likely Diagnoses
- Chronic Liver Disease/Cirrhosis: Conditions like alcoholic liver disease, hepatitis B and C, and non-alcoholic fatty liver disease can lead to portal hypertension, causing splenic enlargement.
- Lymphoma: Both Hodgkin's and non-Hodgkin's lymphoma can cause splenomegaly due to the accumulation of malignant cells in the spleen.
- Infectious Diseases (e.g., Malaria, Tuberculosis): Certain infections can cause splenic enlargement, especially in endemic areas or in individuals with specific risk factors.
- Hematological Disorders (e.g., Hereditary Spherocytosis, Sickle Cell Disease): These conditions can lead to splenomegaly due to the sequestration of abnormal red blood cells.
Do Not Miss Diagnoses
- Splenomegaly due to Portal Vein Thrombosis: This condition can lead to severe complications, including intestinal ischemia and variceal bleeding, if not promptly diagnosed and treated.
- Lymphoproliferative Disorders (e.g., Leukemia): Acute or chronic leukemias can cause significant splenomegaly and have a high mortality rate if not diagnosed and treated early.
- Sickle Cell Sequestration Crisis: In patients with sickle cell disease, a sequestration crisis can lead to rapid enlargement of the spleen, which is a medical emergency.
Rare Diagnoses
- Gaucher's Disease: A genetic disorder leading to the accumulation of glucocerebroside in the spleen, causing enlargement.
- Amyloidosis: The deposition of amyloid proteins in the spleen can result in splenomegaly.
- Sarcoidosis: Although more commonly affecting the lungs, sarcoidosis can also involve the spleen, leading to enlargement.
- Primary Splenic Neoplasms (e.g., Lymphangioma, Hemangioma): These are rare, benign tumors that can cause splenomegaly.