A Case of Massive Splenomegaly Due to Chronic Myeloproliferative Neoplasm

A 34-year-old female, HIV non-reactive, presented to Kamuzu Central Hospital (KCH) in Lilongwe, Malawi, complaining of 7 months abdominal pain. She endorsed shortness of breath and early satiety for the same duration, but denied fever, chills, night sweats, and weight loss. The remainder of her review of systems was negative. She had no significant past medical history. There were no identifiable risk factors for myeloproliferative disorders, including family history, known genetic syndromes, chemical exposure, or history of ionizing radiation. On physical exam, she was noted to have a visible spleen (figure 1) which crossed into the right upper quadrant as well as the pelvis, and was non-tender to palpation. There was no cervical or axillary lymphadenopathy. The remainder of her exam was unremarkable.