Enlarged spleen (splenomegaly)
What the FAA's documents say about enlarged spleen (splenomegaly), in plain words, with the FAA's own words one press away.
FAA term: Splenomegaly
Short version
The FAA's table has one row for it.
| Situation | What the examiner does | Pathway |
|---|---|---|
| Row ANoted on progress notes, the problem list or imaging | Defers to the FAA | Special Issuance |
Show the FAA's words: the FAA's table for Enlarged spleen (splenomegaly)
- Row A · Special Issuance
Splenomegaly noted on progress notes or the problem list, or on imaging (CT or ultrasound). The table lists what to submit for FAA review. The examiner defers, submits the information to the FAA for a possible Special Issuance, and summarizes the findings in Item 60. If it is due to an underlying condition, the table says see that page.
A. Splenomegaly noted on progress notes/problem list or imaging (CT/ultrasound) … Submit the following for FAA review: … DEFER Submit the information to the FAA for a possible Special Issuance. Summarize findings in Item 60. If due to an underlying condition, see that page.
The FAA pathways for enlarged spleen (splenomegaly)
Your step-by-step plan
Step 1: The progress note
From your treating physician, and the table's item on the etiology and date diagnosed.Progress note
Within 90 days before the examA current, detailed progress note from a clinic visit with your treating physician, no more than 90 days before the exam.
It should include
- A summary of the history of the condition or diagnosis
- Current medications, dosages, and side effects (if any)
- Clinical exam findings
- Results of any testing performed
- Diagnosis
- Assessment and plan (prognosis)
- Follow-up
Etiology and date diagnosed
The table's second item: it must specifically include etiology and date diagnosed.
Show the FAA's words: The progress note
1. A current, detailed Clinical Progress Note generated from a clinic visit with their treating physician no more than 90 days before the AME exam.
FAA source: Splenomegaly Disposition Table. FAA date 30 September 2026; checked by Crosscheck 14 October 2026.
It should include a summary of the history of the condition or diagnosis; current medications, dosages, and side effects (if any); clinical exam findings; results of any testing performed; diagnosis; assessment and plan (prognosis); and follow-up.
FAA source: Splenomegaly Disposition Table. FAA date 30 September 2026; checked by Crosscheck 14 October 2026.
2. It must specifically include: Etiology and date diagnosed.
FAA source: Splenomegaly Disposition Table. FAA date 30 September 2026; checked by Crosscheck 14 October 2026.
Step 2: Imaging, the CBC and other testing
Reports and results the table lists.Initial and most recent imaging reports
Copies of the initial and most recent MRI, CT, PET scan or ultrasound(s) already performed.
Complete blood count (CBC)
Within 90 days before the examA complete blood count (CBC), performed within the past 90 days.
Other testing already performed
If already performed.
If already performed.
Results of any other testing already performed by your treating physician.
Show the FAA's words: Imaging, the CBC and other testing
3. Imaging reports: Copies of the initial and most recent MRI, CT, PET scan or ultrasound(s) already performed. In some cases, actual images may be required after review.
FAA source: Splenomegaly Disposition Table. FAA date 30 September 2026; checked by Crosscheck 14 October 2026.
4. Lab: Complete blood count (CBC), performed within the past 90 days:
FAA source: Splenomegaly Disposition Table. FAA date 30 September 2026; checked by Crosscheck 14 October 2026.
5. Results of any other testing already performed by the treating physician.
FAA source: Splenomegaly Disposition Table. FAA date 30 September 2026; checked by Crosscheck 14 October 2026.
What the examiner checks
Row ADefers to the FAASpecial Issuance
The table lists what to submit for FAA review. The examiner defers, submits the information to the FAA for a possible Special Issuance, and summarizes the findings in Item 60. If it is due to an underlying condition, the table says see that page.
If the examiner defers
Show the FAA's words: what the examiner does on each row
- Row A · Special Issuance
Splenomegaly noted on progress notes or the problem list, or on imaging (CT or ultrasound). The table lists what to submit for FAA review. The examiner defers, submits the information to the FAA for a possible Special Issuance, and summarizes the findings in Item 60. If it is due to an underlying condition, the table says see that page.
A. Splenomegaly noted on progress notes/problem list or imaging (CT/ultrasound) … Submit the following for FAA review: … DEFER Submit the information to the FAA for a possible Special Issuance. Summarize findings in Item 60. If due to an underlying condition, see that page.
If the examiner defersSpecial Issuance
The table's one row, splenomegaly noted on progress notes or the problem list, or on imaging, is marked DEFER.
What the FAA lists to send
- Item 1. A current, detailed clinical progress note generated from a clinic visit with the treating physician no more than 90 days before the exam.
- Item 2. The table's second item, which reads that it must specifically include the etiology and date diagnosed. The item does not say what "it" refers to.
- Item 3. Copies of the initial and most recent MRI, CT, PET scan or ultrasound(s) already performed. In some cases, actual images may be required after review.
- Item 4. A complete blood count (CBC), performed within the past 90 days.
- Item 5. Results of any other testing already performed by the treating physician.
Show the FAA's words: if the examiner defers
When the examiner defers
- Reason 1
The table's one row, splenomegaly noted on progress notes or the problem list, or on imaging, is marked DEFER.
A. Splenomegaly noted on progress notes/problem list or imaging (CT/ultrasound) … DEFER Submit the information to the FAA for a possible Special Issuance.
What the FAA lists to send
- Item 1
A current, detailed clinical progress note generated from a clinic visit with the treating physician no more than 90 days before the exam.
1. A current, detailed Clinical Progress Note generated from a clinic visit with their treating physician no more than 90 days before the AME exam.
- Item 2
The table's second item, which reads that it must specifically include the etiology and date diagnosed. The item does not say what "it" refers to.
2. It must specifically include: Etiology and date diagnosed.
- Item 3
Copies of the initial and most recent MRI, CT, PET scan or ultrasound(s) already performed. In some cases, actual images may be required after review.
3. Imaging reports: Copies of the initial and most recent MRI, CT, PET scan or ultrasound(s) already performed. In some cases, actual images may be required after review.
- Item 4
A complete blood count (CBC), performed within the past 90 days.
4. Lab: Complete blood count (CBC), performed within the past 90 days:
- Item 5
Results of any other testing already performed by the treating physician.
5. Results of any other testing already performed by the treating physician.
What a Special Issuance is
The Guide says an Authorization for Special Issuance, valid for a specified period, may be granted at the Federal Air Surgeon's discretion to a person who does not meet the established medical standards, if the person shows to the satisfaction of the Federal Air Surgeon that the duties authorized by the class of certificate applied for can be performed without endangering public safety during the period the Authorization would be in force.
How the FAA pathways workGood to know
Points from the FAA's own documents that are easy to miss.
What a progress note must include
In most cases it should come from a visit with the treating physician no more than 90 days ago, and cover the history, medications with dosages and side effects, exam findings, test results, diagnosis, assessment and plan, prognosis and follow-up. The FAA's sheet says to make sure the physician adds the prognosis. A portal note or an After Visit Summary that does not meet these criteria is not enough, and neither is a simple "ok to fly" letter. The FAA's documents also call it a status report.
Show the FAA's words: good to know, 1
your patient portal to print out “notes” or an “After Visit Summary (AVS).” … Patient Portal notes or an AVS that do not meet the criteria listed below for a detailed Clinical Progress Note are NOT sufficient for FAA purposes. … To be “current,” in MOST CASES, the detailed Clinical Progress Note should be from an evaluation in which you saw your treating physician no more than 90 days ago. … It Must include the following items: … A summary of the history of the condition, … Current medications, dosages, and side effects (if any); … Clinical exam findings; … Results of any testing performed; … Diagnosis; … Assessment and Plan; … Prognosis (This item may not be on a standard progress note, make sure your physician adds this information.); and … Follow-up … Please note: A letter stating, “Mr. Smith is ok to fly” (or any other simple note), is NOT a current, detailed Clinical Progress Note and is NOT acceptable. … You may also see this called a “current status report” or “status report” in current FAA Guidance. Any reference to a “status report” equals the criteria listed on this sheet.
Etiology and date diagnosed
The table's second item reads that it must specifically include the etiology and date diagnosed. The item does not say what "it" refers to.
Show the FAA's words: good to know, 2
2. It must specifically include: Etiology and date diagnosed.
Actual images may be asked for
The table asks for copies of the imaging reports, and says that in some cases actual images may be required after review.
Show the FAA's words: good to know, 3
3. Imaging reports: Copies of the initial and most recent MRI, CT, PET scan or ultrasound(s) already performed. In some cases, actual images may be required after review.
If due to an underlying condition
The table says that if the splenomegaly is due to an underlying condition, see that page.
Show the FAA's words: good to know, 4
If due to an underlying condition, see that page.
FAA sources
Every FAA document this page relies on, with the FAA's own date and the date Crosscheck last read it. The documents to print open at the FAA, so they are always the FAA's current ones.
This reports what the FAA has published. It is not medical advice, and it does not say how the FAA or an examiner will decide a case.