SPLENOMEGALY IN 2,505 PATIENTS AT A LARGE UNIVERSITY MEDICAL-CENTER FROM 1913 TO 1995 - 1913 TO 1962 - 2,056 PATIENTS

Splenomegaly was studied retrospectively at the University of Californ ia, San Francisco, School of Medicine, on all patients (N = 2,056) for the years 1913 to 1962. The patients were classified into several dia gnostic groups, and these groups were tested for statistical significa nce (chi(2)) With many clinical and laboratory variables to determine their predictive value. Hematologic disorders were associated with 57% of cases of splenomegaly and 81% of cases of massive splenomegaly. Am ong patients with splenomegaly, 19% had infectious diseases, 11% had h epatic diseases, and 9% had congestive or inflammatory disorders. The residual 4% were considered to have primary splenic disorders or a dis order of unknown cause. The commonest diseases associated with splenom egaly were hematologic (acute and chronic leukemias), infectious (mala ria, endocarditis, and tuberculosis), hepatic (chronic liver disease), congestive (congestive heart failure), inflammatory (thyrotoxicosis), and other (cancers not metastatic to the spleen). The diseases most f requently associated with massive splenomegaly were the chronic leukem ias. The disease with the highest incidence of massive splenomegaly wa s myelofibrosis (23 of 29 patients, 78%). Splenectomy was performed in 154 patients (7%), primarily for hematologic amelioration and hepatic hypersplenism. Hematologic diseases showed significant associations w ith lymphadenopathy, generalized lymphadenopathy, massive splenomegaly , and cytoses (P.001) and with progressive splenic enlargement (P<.02) . Infectious diseases showed significant association with fever, and h epatic diseases showed significant association with abnormal results o f liver function tests (P <.001). The findings of this retrospective s tudy should be validated prospectively.