Ascites in chronic leukemia: a case report and review of the literature

Ascites is a common manifestation of solid tumors, but is unusual secondary to reticuloendothelial and lymphoproliferative malignancies. This report describes a case of chronic lymphocytic leukemia whose relapse was heralded by splenomegaly with massive ascites. A 2,750 g spleen was removed which showed extensive infiltration with lymphocytes. The portal areas of the liver were similarly infiltrated. This hepatic and splenic involvement most likely produced portal hypertension which resulted in ascites. The formation of ascites in such patients heralds a short survival, since it is probably one of the manifestations of the accelerated form of the disease.