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即将发生的脾破裂作为非典型慢性淋巴细胞白血病的指标:来自沙特阿拉伯的一例病例报告

Impending splenic rupture as indicator of atypical chronic lymphocytic leukemia: A case report from Saudi Arabia.

作者信息

Al-Ansari Rehab Y, Al-Rayes Hezab, Abdalla Leena Mohamed, Alshehri Abdulaziz Abdullah, Woodman Alexander

机构信息

Adult Hematology Unit, Internal Medicine Department, King Fahd Military Medical Complex, Dhahran, Saudi Arabia.

Internal Medicine Department, King Fahd Military Medical Complex, Dhahran, Saudi Arabia.

出版信息

Int J Surg Case Rep. 2023 Sep;110:108748. doi: 10.1016/j.ijscr.2023.108748. Epub 2023 Sep 2.

Abstract

BACKGROUND

Chronic lymphocytic leukemia (CLL) is one of the hematological malignancies in which the bone marrow overproduces mature, dysfunctional lymphocytes. Affected lymphocytic cells can affect the lymph nodes, spleen, liver, bone marrow, and rarely other organs. Spontaneous rupture of the spleen is a rare health condition, with a few cases caused by CLL. Since the preliminary presentation of either impending or real splenic rupture is unusual and requires recording and reporting, this case report was developed.

CASE REPORT

A 55-year-old male patient presented with a significant weight loss of 20 kg, loss of appetite, fatigue, abdominal pain, and early satiety. Clinical examination revealed massive splenomegaly 22 cm below the costal margin, otherwise unremarkable on systemic examination. The size and dimensions of the spleen were confirmed by computed tomography of the body. The patient underwent a bone marrow biopsy, which was suggestive of atypical CLL. Due to the rapid progression of the size of the spleen and the pattern of impending rupture of the spleen, an emergency splenectomy was performed, and the histopathological report confirmed low-grade B-cell non-Hodgkin's lymphoma, mostly typical of CLL.

CONCLUSION

Given the rarity of cases, continuous data recording and reporting is required to enrich the scientific literature and share experiences from case to case. This will create a complete picture of this health condition across diverse regions and countries.

摘要

背景

慢性淋巴细胞白血病(CLL)是一种血液系统恶性肿瘤,骨髓会过度产生成熟的、功能失调的淋巴细胞。受影响的淋巴细胞可累及淋巴结、脾脏、肝脏、骨髓,很少累及其他器官。脾自发性破裂是一种罕见的健康状况,少数病例由CLL引起。由于脾即将破裂或已破裂的初步表现不常见,需要记录和报告,因此撰写了本病例报告。

病例报告

一名55岁男性患者出现体重显著减轻20千克、食欲不振、疲劳、腹痛和早饱症状。临床检查发现脾肿大明显,肋缘下22厘米,全身检查其他方面无异常。通过全身计算机断层扫描确认了脾脏的大小和尺寸。患者接受了骨髓活检,提示为非典型CLL。由于脾脏大小迅速增大且有即将破裂的迹象,遂进行了急诊脾切除术,组织病理学报告证实为低级别B细胞非霍奇金淋巴瘤,大多为典型的CLL。

结论

鉴于病例罕见,需要持续记录和报告数据,以丰富科学文献并逐例分享经验。这将全面了解不同地区和国家的这种健康状况。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f6b2/10509882/b4797107e223/gr1.jpg

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