What does enlarged spleen and normal Blood mean?

[pennstatepride]

Hello, and thank u in advance for your response. I will lsit my symptoms etc.
23 year old male.
1 month ago went for ultrasound b/c of right side pain and elevated liver enzymes.
Ultrasound found enlarged liver/spleen
1 week later liver enzymes were back to normal and CAT scan showed liver within normal range, but spleen was 15cm with no mass.
Did a CBC again, and blood was all within normal range.
Now, 1 month later I had bloodwork done again, and CBC w/differential was normal and blood smear was normal as well.
SED Rate was normal
Feel fine, and have had no fever; I have had 1 swollen node on the back of my head behind my ear for 6-7 months now, it is painless and about the size of a pea. I do not think it has grown at all in size.
I also have had 2 nodes on each side of the back of my head that I can feel, but are about the size of a pea as well.

I am due to see a hematologist soon, but am wondering what you think is or is not wrong with me based on your past experiences. I am extremely worried, and do not know what to put into have a normal cbc and blood smear. Are these nodes anything to worry about? Thanks a lot, I really appreciate it.

[Dr. Safaa Mahmoud]

Hello,

Causes of elevated liver enzyme together with mild hepatosplenomegally are many. Of them recent infections, medications, alcohol, fatty liver, cancer (leukemia) etc. Benign (familial) causes are also known to give similar clinical picture.

It would be more helpful if you can provide us information about the exact level of your enzymes, any history of medications, recent alcohol intake, history of recent infections (fever), transfusions, surgery and any relative family history.

It sounds like a transient cause (like infection, medication, alcohol) is the reason of your conditions since enzymes went back to normal in a short time and the recent liver image excluded any liver abnormalities.

The normal adult spleen size although slightly varies from one person to another, by CT scan it measures approximately 12–15 cm in length, 4–8 cm in antero-posterior diameter and 3–4 cm in thickness.

CBC, LDH and ESR are usually requested while investigating for hepatosplenomegally.
It is reassuring that your blood counts, ESR are normal and liver enzymes went back to normal levels in a short period. However, follow up with blood picture and a thorough clinical examination and imaging to exclude serious causes is essential.

I would advise you to follow up with your doctor and to discuss with him the results of your CT scan to exclude any abnormalities in the spleen.

Please keep us updated.
Best regards.