Internal Medicine, Rosalind Franklin University of Medicine and Science, North Chicago, Illinois, USA.
Internal Medicine, Rosalind Franklin University of Medicine and Science, North Chicago, Illinois, USA
BMJ Case Rep. 2021 Oct 20;14(10):e242193. doi: 10.1136/bcr-2021-242193.
Though rare, atraumatic rupture of the spleen can be a complication in certain leukaemias and lymphomas. We present a unique case of atraumatic rupture of the spleen in a patient with chronic lymphocytic leukaemia. The patient presented to the emergency department with abdominal pain; he had been on ibrutinib therapy but stopped taking the medication abruptly 6 days prior. On evaluation, he was found to have a ruptured spleen with a haemoperitoneum. Pathology of the excised spleen showed infiltration of the spleen with hyperproliferated CD5+ intermediate-to-large cells, consistent with B-cell lymphoma and favouring Richter's transformation. There are only a few available reports of patients with similar presentations identified in our literature review.
虽然罕见，但脾脏无创伤性破裂可能是某些白血病和淋巴瘤的并发症。我们报告了一例慢性淋巴细胞白血病患者的脾脏无创伤性破裂的独特病例。该患者因腹痛就诊于急诊科，他一直在接受伊布替尼治疗，但在 6 天前突然停止服药。评估发现，他的脾脏破裂，伴有血腹。切除脾脏的病理显示脾脏浸润有过度增生的 CD5+ 中等至大细胞，符合 B 细胞淋巴瘤，并支持里希特转化。在我们的文献复习中，仅发现少数具有类似表现的患者的报道。
