M spleen size on CT scan is 17.6 cm. My blood work is all normal. I have a slightly fatty liver. Is this somethingi shuld be concerned about?

Liver issues? Splenomegaly (enlarged spleen) may be caused from liver issues. The liver can be fatty from problems with cholesterol, toxins such as alcohol, or having too much total body fat. Reviewing labs, imaging, and history with a primary or specialist physician may clarify.