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 anaemia, weakness, fatigue, and often, an enlarged spleen and liver. Splenomegaly can be massive and is occasionally the presenting symtpom, with pain, early satiety, fever and left sided tenderness. It is crucial to rule out splenic infaction, becasue left-sided pain is not uncommon in myelofibrosis, a disease in which screen is usually markedly enlarged. Splenic infarction should easily be ruled out with CT scan; ultrasound can also be used but is less sensitive. Another option is PET. Reported 18F-FDG 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.
S S Saboo et al, Spleen in haematological malignancies: spectrum of imaging findings
Br. J. Radiol. January 1, 2012 85:81-92
Sandeep Chunduri et al, Pulmonary extramedullary hematopoiesis in patients with myelofibrosis undergoing allogeneic stem cell transplantation
haematol October 1, 2008 vol. 93 no. 10 1593-1595
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