Polycythemia vera 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]

Overview

Abdominal and chest CT scan may be helpful in the diagnosis of polycythemia vera. Findings on CT scan suggestive of polycythemia vera include enlarged lymph nodes, splenomegaly, and splanchnic venous thrombosis.

CT

CT plays a significant role in the further assessment of polycythemia vera and its complications. CT can assist with detection of:

• Enlarged lymph nodes (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 polycythemia vera, as extramedullary hematopoiesis occurs in the spleen. 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 polycythemia vera and other myeloproliferative neoplasms.
• Splanchnic venous thrombosis: Patients with polycythemia vera can develop thromboses at unusual sites, including mesenteric vasculature such as the portal vein, superior mesenteric vein, and inferior mesenteric vein.
• Pulmonary embolism:

References

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