Hydrocortisone valerate is a synthetic glucocorticoid corticosteroid and a corticosteroid ester. == References ==
In patients where the likelihood of splenomegaly is high, the physical exam is not sufficiently sensitive to detect it; abdominal imaging is indicated in such patients.In cases of infectious mononucleosis splenomegaly is a common symptom and health care providers may consider using abdominal ultrasonography to get insight into a persons condition. However, because spleen size varies greatly, ultrasonography is not a valid technique for assessing spleen enlargement and should not be used in typical circumstances or to make routine decisions about fitness for playing sports. Causes
The most common causes of splenomegaly in developed countries are infectious mononucleosis, splenic infiltration with cancer cells from a hematological malignancy and portal hypertension (most commonly secondary to liver disease, and sarcoidosis). Splenomegaly may also come from bacterial infections, such as syphilis or an infection of the hearts inner lining (endocarditis). Splenomegaly also occurs in mammals parasitized by Cuterebra fontinella.The possible causes of moderate splenomegaly (spleen <1000 g) are many, and include:

The causes of massive splenomegaly (spleen >1000 g) are

chronic myelogenous leukemia
myelofibrosis
malaria
splenic marginal zone lymphoma

Pathophysiology
Splenomegaly can be classified based on its pathophysiologic mechanism:

Congestive, by pooled blood (e.g., portal hypertension)
Infiltrative, by invasion by cells foreign to the splenic environment (e.g., metastases, myeloid neoplasms, lipid storage diseases)
Immune, by an increase in immunologic activity and subsequent hyperplasia (e.g., endocarditis, sarcoidosis, rheumatoid arthritis)
Neoplastic, when resident immune cells originate a neoplasm (e.g., lymphoma). Diagnosis
Abdominal CT is the most accurate and spleen need to be larger 2-3 times to be palpable below the costal margin in physical examination that can help in diagnosis.