How do you workup splenomegaly related to possible hematologic etiology in the absence of abnormal blood counts, adenopathy or severe constitutional symptoms?

The presence of splenomegaly is an important finding found either on physical exams or by imaging. As noted in the question, the initial work up includes physical exam looking for lymphadenopathy. In addition, laboratory evaluation, including absolute white count, and differential may help explain why it is present. The presence of symptoms including fever, night sweats, and weight loss may suggest hematologic malignancy. However, the major consideration should include infections such as Epstein-Barr virus, underlying liver disease. Or due to hematologic illness. When searching for a hematologic cause one should consider it. Laboratory work up for hemolytic anemia, underlying lymphoproliferative, disease, or splenic infiltration due to muco...