Myeloid Neoplasms in the Liver and Spleen

The spleen and, to a lesser extent, the liver may be secondarily involved by myeloid neoplasms. Clinically, the assessment of patients for hepatomegaly and splenomegaly is a routine part of the physical exam. Ultrasound imaging may be helpful for monitoring organ size. Splenic pathology is more commonly documented in chronic myeloid neoplasms, such as chronic myeloid leukemia (CML), primary myelofibrosis (PMF), chronic myelomonocytic leukemia (CMML), and, in a minority of cases, advanced stages of polycythemia vera (PV) or essential thrombocythemia (ET). Rarely, acute myeloid leukemia can involve the spleen, generally with only mild to moderate organomegaly. Less is known about hepatic involvement in myeloid neoplasms. However, hepatomegaly and hepatic dysfunction can be seen in myeloid neoplasms, due either to reactive proliferations of the hepatocytes themselves or infiltration of the liver by hematopoietic cells.