{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,11]],"date-time":"2025-09-11T22:33:43Z","timestamp":1757630023956,"version":"3.44.0"},"reference-count":26,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2025,7,23]],"date-time":"2025-07-23T00:00:00Z","timestamp":1753228800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Internal Medicine Journal"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Splenomegaly is an important finding in numerous conditions. Most reported cohort studies have not included modern diagnostic methods, such as functional imaging.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>We aimed to determine the utility of newer diagnostic methods and provide an updated approach to splenomegaly by examining recent experience at our centre.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We conducted a retrospective review of adult patients with splenomegaly of unknown cause using imaging reports over 12 months. We used an upper limit of 13 cm and applied a validated height\u2010 and sex\u2010adjusted formula (SplenoCalc) where possible. Data were analysed using Fisher's exact test on Graphpad Prism software.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Liver pathology was identified in 24%, infectious disease in 19%, haematological disease in 18%, inflammatory disease in 8% and no diagnosis in 28%. Patients who had an 18\u2010F\u2010fluorodeoxyglucose positron emission tomography (FDG PET) scan were significantly more likely to undergo a biopsy (25\/38 vs. 23\/103, <jats:italic>P<\/jats:italic> &lt;\u20090.0001) and reach a diagnosis (34\/38 vs. 84\/126, <jats:italic>P<\/jats:italic> =\u20090.007). Eight per cent of assessable patients had a spleen size within normal limits when the SplenoCalc formula was applied. Untreated human immundodeficiency virus (HIV) was identified in 8% of tested patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In our cohort, PET scanning, where appropriate, was valuable in identifying sites for biopsy and establishing a cause for splenomegaly, particularly haematological or inflammatory. Routine recording of height and use of the SplenoCalc formula in imaging departments may avoid unnecessary investigation of people with normal sized spleens. Due to the prevalence of untreated HIV in our cohort, we would also recommend HIV testing in all patients with splenomegaly.<\/jats:p><\/jats:sec>","DOI":"10.1111\/imj.70155","type":"journal-article","created":{"date-parts":[[2025,7,23]],"date-time":"2025-07-23T11:14:45Z","timestamp":1753269285000},"page":"1516-1523","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Clinico\u2010pathologic characteristics, updated diagnostic approach and value of positron emission tomography for adults with splenomegaly at a large, university hospital"],"prefix":"10.1111","volume":"55","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4844-3498","authenticated-orcid":false,"given":"Huw","family":"Richards","sequence":"first","affiliation":[{"name":"Department of Haematology University College London Hospitals NHS Foundation Trust  London UK"},{"name":"Department of Haematology Royal Free London NHS Foundation Trust  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adam","family":"Gray","sequence":"additional","affiliation":[{"name":"Hospital of Tropical Diseases University College London Hospitals NHS Foundation Trust  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jawad","family":"Saeed","sequence":"additional","affiliation":[{"name":"Department of Haematology University College London Hospitals NHS Foundation Trust  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ethan","family":"Troy\u2010Barnes","sequence":"additional","affiliation":[{"name":"Department of Haematology University College London Hospitals NHS Foundation Trust  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stefan","family":"Voo","sequence":"additional","affiliation":[{"name":"Institute of Nuclear Medicine University College London Hospitals NHS Foundation Trust  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Irfan","family":"Kayani","sequence":"additional","affiliation":[{"name":"Institute of Nuclear Medicine University College London Hospitals NHS Foundation Trust  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Simon","family":"Wan","sequence":"additional","affiliation":[{"name":"Institute of Nuclear Medicine University College London Hospitals NHS Foundation Trust  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Brown","sequence":"additional","affiliation":[{"name":"Hospital of Tropical Diseases University College London Hospitals NHS Foundation Trust  London UK"},{"name":"Clinical Research Department London School of Hygiene and Tropical Medicine  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher","family":"McNamara","sequence":"additional","affiliation":[{"name":"Department of Haematology University College London Hospitals NHS Foundation Trust  London UK"},{"name":"Department of Haematology Royal Free London NHS Foundation Trust  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,7,23]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000441-199610000-00003"},{"key":"e_1_2_7_3_1","first-page":"78","article-title":"Splenomegaly in 2,505 patients at a large university medical center from 1913 to 1995\u20131913 to 1962: 2,056 patients","volume":"169","author":"O'Reilly RA","year":"1998","journal-title":"West J Med"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1159\/000040975"},{"key":"e_1_2_7_5_1","first-page":"74","article-title":"Splenomegaly \u2013 diagnostic validity, work\u2010up, and underlying causes","volume":"12","author":"Rotbain EC","year":"2017","journal-title":"PLoS One"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.blre.2008.10.001"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.2015150887"},{"key":"e_1_2_7_8_1","first-page":"139","volume-title":"Diagnostic Ultrasound","author":"Vos PM","year":"2018"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00259-020-04913-9"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/RLU.0b013e3182443b78"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2013.53.5229"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.sult.2006.06.005"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.2214\/ajr.184.1.01840045"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1136\/bjsm.2005.022376"},{"key":"e_1_2_7_15_1","first-page":"705","article-title":"Splenomegaly without an apparent cause","volume":"155","author":"Knudson P","year":"1982","journal-title":"Surg Gynecol Obstet"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1001\/archsurg.137.1.64"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/joim.12104"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0025-6196(24)00530-5"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.28431"},{"key":"e_1_2_7_20_1","first-page":"1449","article-title":"Noncirrhotic human nonalcoholic fatty liver disease induces portal hypertension in relation to the histological degree of steatosis","volume":"22","author":"Francque S","year":"2010","journal-title":"Eur J Gastroenterol Hepatol"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2012.05.008"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2141.2012.09146.x"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1981.03320240064029"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjh.17325"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0463.2006.apm_378.x"},{"key":"e_1_2_7_26_1","doi-asserted-by":"publisher","DOI":"10.1002\/jcu.20608"},{"key":"e_1_2_7_27_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.1085"}],"container-title":["Internal Medicine Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/imj.70155","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,10]],"date-time":"2025-09-10T16:06:16Z","timestamp":1757520376000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/imj.70155"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7,23]]},"references-count":26,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2025,9]]}},"alternative-id":["10.1111\/imj.70155"],"URL":"https:\/\/doi.org\/10.1111\/imj.70155","archive":["Portico"],"relation":{},"ISSN":["1444-0903","1445-5994"],"issn-type":[{"type":"print","value":"1444-0903"},{"type":"electronic","value":"1445-5994"}],"subject":[],"published":{"date-parts":[[2025,7,23]]},"assertion":[{"value":"2022-11-07","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-06-08","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-07-23","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}