Myeloproliferative neoplasm CT

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Mohamad Alkateb, MBBCh [2] Shyam Patel [3]


Abdominal and chest CT scan may be helpful in the diagnosis of myeloproliferative neoplasm. Findings on CT scan suggestive of myeloproliferative neoplasm include enlarged lymph nodes, hepatosplenomegaly, splanchnic venous thrombosis, and pulmonary embolism.


Abdominal and chest CT scan may be helpful in the diagnosis of myeloproliferative neoplasm. CT can assist with detection of:

  • Lymphadenopathy: Malignant hematologic disease is commonly associated with enlargement of lymph nodes. CT can quantify the degree of lymphadenopathy and can accurate measure lymph node size.
  • Splenomegaly: Enlargement of the spleen is frequently found in patients with myeloproliferative neoplasms, as extramedullary hematopoiesis occurs in the spleen.[1] CT can quantitate spleen size, and serial CTs are sometimes useful for assessment of interval changes in clinical condition. CT of the abdomen is more sensitive that abdominal ultrasound for detection of splenomegaly, although the cost of CT is higher and there is a risk for radiation-induced cancers.
  • Hepatomegaly: CT can quantitate liver size. This is sometimes useful in patients with myeloproliferative neoplasms.[1]
  • Splanchnic venous thrombosis: Patients with myeloproliferative neoplasms can develop thromboses at unusual sites, including mesenteric vasculature such as the portal vein, superior mesenteric vein, and inferior mesenteric vein. Thrombosis is most common in polycythemia vera and essential thrombocythemia.[2]
  • Pulmonary embolism: CT angiography of the chest is the optimal test for assessment for thrombosis of the pulmonary vasculature. Venous thromboembolism events are common in patients with high-risk polycythemia vera.[2]


  1. 1.0 1.1 Mitra D, Kaye JA, Piecoro LT, Brown J, Reith K, Mughal TI; et al. (2013). "Symptom burden and splenomegaly in patients with myelofibrosis in the United States: a retrospective medical record review". Cancer Med. 2 (6): 889–98. doi:10.1002/cam4.136. PMC 3892393. PMID 24403262.
  2. 2.0 2.1 Michiels JJ (2015). "Myeloproliferative and thrombotic burden and treatment outcome of thrombocythemia and polycythemia patients". World J Crit Care Med. 4 (3): 230–9. doi:10.5492/wjccm.v4.i3.230. PMC 4524819. PMID 26261774.

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