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Unique case of atraumatic splenic rupture in a patient with chronic lymphocytic leukaemia with Richter's

Swetha Paduri1, Nitish Singh Nandu2, Thomas Brucker3

  • 1Internal Medicine, Rosalind Franklin University of Medicine and Science, North Chicago, Illinois, USA.

BMJ Case Reports
|October 21, 2021
PubMed

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.

Keywords:
haematology (incl blood transfusion)oncology

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