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Application of Laparoscopic Partial Splenectomy with Total Blood Flow Occlusion in Benign Splenic Lesions

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Published on: December 20, 2024

Myeloma Presenting with Massive Splenomegaly.

P Jacobs¹, L Wood¹, P Close²

¹a The Department of Haematology and the Bone Marrow Transplant Unit , Constantiaberg Medi-Clinic , Burnham Road, Plumstead 7800, Cape Town , South Africa.

Hematology (Amsterdam, Netherlands)

|July 15, 2016

Summary

Marked splenomegaly, an unusual initial symptom of myeloma, was observed in two patients. The exact cause of spleen enlargement in these cases remains unclear despite investigations.

Keywords:

Splenomegaly immunohistochemistry myeloma

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Area of Science:

Hematology
Oncology
Pathology

Background:

Multiple myeloma commonly causes skeletal damage, anemia, and renal failure.
Splenomegaly is a rare presenting symptom of myeloma, with its pathophysiology often unclear.

Purpose of the Study:

To report two unique cases of myeloma presenting with significant splenomegaly as the initial symptom.
To investigate the underlying pathology of splenomegaly in these myeloma patients.

Main Methods:

Case report of two patients with myeloma and marked splenomegaly.
Histopathological examination of spleen tissue post-splenectomy.
Immunohistochemical analysis to identify plasma cell infiltration.

Main Results:

Both patients presented with severe splenomegaly causing pain and infarction, necessitating splenectomy.
Histology revealed sinus lining cell proliferation with IgA paraprotein in one case and red pulp expansion in the other.
Plasma cell infiltration of the spleen was not confirmed despite unusual morphology in peripheral blood and marrow.

Conclusions:

Splenomegaly can be an unusual initial presentation of myeloma.
The pathophysiology of splenomegaly in these cases remains obscure and requires further investigation.
These cases highlight the diverse and sometimes atypical manifestations of multiple myeloma.