Myelofibrosis is a bone marrow disorder that disrupts the body’s normal production of blood cells. The result is extensive scarring in the bone marrow, leading to severe anemia, weakness, fatigue, and often, an enlarged spleen and liver. The enlarged spleen can produce symptoms and it can be massive. Occasionally the presenting symptom is pain, feeling full after eating just a little (early satiety), fever and left sided tenderness. It is crucial to rule out splenic infarction when there is fever or pain. Splenic infarction should easily be ruled out with CT scan; ultrasound can also be used but is less sensitive. Another option is PET. Reported and expected PET scan findings in myelofibrosis include diffuse significantly increased FDG uptake in the massively enlarged spleen and liver with diffuse increased uptake in bone marrow.
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