AML and splenomegaly?

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MudPhud20XX

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A 35-year-old man has a worsening productive cough for a month. On physical examination, he has small nontender lymph nodes palpable in axillae, and the tip of his spleen is palpable. Laboratory studies show Hgb 10 g/dL, Hct 31%, MCV 90 fL, WBC count 79,000/µL, and platelet count 30,000/µL. Microscopic examination of his peripheral blood smear shows many blasts with Auer rods. Which of the following is the most likely diagnosis?

AML is the answer of course. I am wondering if palpable spleen (splenomegaly) is associated with AML. Any idea?

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Most leukemias can present with a palpable spleen by one of two mechanisms:
(1) Spread of leukemic cells into the spleen
(2) Extramedullary hematopoiesis (in the spleen) due to pancytopenia (bone barrow being full of neoplastic WBCs presents popper development of blood elements)
 
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