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Published on: March 30, 2018
Pathologic splenic rupture as the presentation of mantle cell lymphoma
A H Strickland1, K A Marsden, J McArdle
1Clinical Haematology & Medical Oncology Unit; Royal Hobart Hospital, Hobart, Australia.
Abstract:
Pathologic splenic rupture in non-Hodgkin's lymphoma (NHL) is a rare event, with 32 cases previously reported. Initial presentation of NHL with this complication is even rarer. We report such a case in an 80-year-old man with mantle cell lymphoma (MCL). It is notable that of the previously reported cases of pathologic rupture, three have occurred in MCL, suggesting that patients with this uncommon subtype of NHL may be particularly vulnerable to pathologic splenic rupture. Following splenectomy the patient's disease behaved in a high-grade fashion. Despite an initially encouraging response, his disease ran an aggressive course and he succumbed within four months. This case demonstrates the presentation of MCL with pathologic splenic rupture, as well as the potentially highly malignant behaviour of the disease.
Insights
Pathologic splenic rupture is a rare complication of non-Hodgkin's lymphoma (NHL). This case highlights mantle cell lymphoma (MCL) as a potentially vulnerable subtype, presenting with splenic rupture and aggressive disease progression.
Area of Science:
- Hematology
- Oncology
- Pathology
Background:
- Pathologic splenic rupture is a rare but serious complication of non-Hodgkin's lymphoma (NHL).
- Initial presentation of NHL with splenic rupture is exceptionally uncommon.
- Mantle cell lymphoma (MCL) is an uncommon subtype of NHL.
Observation:
- A case of an 80-year-old male with mantle cell lymphoma (MCL) presenting with spontaneous splenic rupture is described.
- Three prior reported cases of pathologic splenic rupture in NHL also involved MCL.
- The patient underwent splenectomy, after which his MCL exhibited high-grade behavior.
Findings:
- This case represents a rare initial presentation of MCL with pathologic splenic rupture.
- MCL may represent a subtype of NHL with increased vulnerability to splenic rupture.
- The patient's MCL demonstrated aggressive behavior post-splenectomy, leading to a poor prognosis despite initial treatment response.
Implications:
- This case underscores the importance of considering splenic rupture in the differential diagnosis of NHL presentations.
- It suggests a potential predisposition for splenic rupture in patients with MCL.
- The findings highlight the aggressive nature MCL can exhibit, emphasizing the need for vigilant monitoring and timely therapeutic interventions.
