A slightly enlarged spleen in CT examination is not necessarily a problem. It may be caused by physiological factors such as congenital factors, or it may be caused by liver diseases, blood system diseases, infectious diseases, immune system diseases, and so on. 1. Physiological factors: some people’s spleens are larger than normal spleens under normal circumstances, which is congenital, belongs to physiological factors and is a normal phenomenon. 2. Liver diseases: Hepatitis, cirrhosis, liver cancer, hepatic vein or portal vein obstruction and other diseases may cause elevated portal vein pressure, resulting in a slightly larger spleen on CT examination. 3. Hematologic diseases: such as hemolytic anemia, myeloproliferative diseases (e.g., true erythrocytosis, myelofibrosis, etc.), chronic lymphocytic leukemia, etc., which may also cause a slightly enlarged spleen, or even a severely enlarged spleen in the later stages of the disease. 4. Infectious diseases, such as malaria, schistosomiasis and other parasitic diseases, can also cause liver and spleen enlargement. 5. Immune system diseases: such as rheumatoid arthritis, systemic lupus erythematosus, etc., may also enlarge the spleen. In addition, such as lymphoma, plasmacytoma, etc. can also cause spleen enlargement. If the patient is diagnosed with enlarged spleen, it is recommended to consult a doctor in time to identify the cause of the disease and carry out targeted treatment to avoid delaying the condition.