Spontaneous (pathological) splenic rupture in a blastic variant of mantle cell lymphoma: A case report and literature review

Matthew A. Lunning, Maryalice Stetler-Stevenson, Peter T. Silberstein, Vincent Zenger, Gerald E. Marti

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

Spontaneous (pathological) splenic rupture (SPSR) in hematological malignancies is rare. This report describes a 71-year-old male diagnosed with mantle cell lymphoma-blastic variant (MCL-BV) who experienced an SPSR a few days before the initial diagnosis. The patient underwent a splenectomy and recovered without incident. Partial remission was seen following several cycles of CHOP (cyclophosphamide/doxorubicin/vincristine/prednisone). However, relapse was rapid, with leukemic meningitis occurring several months later. It was successfully treated by intrathecal methotrexate and cranial spinal radiation. A progressive lymphocytosis developed, which responded to rituximab. Lymphadenopathy and skin involvement ensued, followed by pneumonia and death. The literature on SPSR in patients with MCL-BV and other lymphoproliferative disorders showed similar clinical and postoperative findings. Clinical presentation included Kehr's sign and acute abdominal pain. Postoperative findings included blood in the peritoneal cavity, multiple splenic hematomas, splenic infarcts, and splenic necrosis. Most strikingly, the majority of the patients reviewed appeared to have undergone some type of blastic transformation. One or any combination of these findings that has been noted above in addition to a bleeding diathesis could be the foundation to SPSR. We recommend consideration of splenic rupture in patients with a lymphoproliferative disorder coupled with rapid progression of marked or massive splenomegaly.

Original languageEnglish (US)
Pages (from-to)117-120
Number of pages4
JournalClinical lymphoma
Volume3
Issue number2
DOIs
StatePublished - Sep 2002

Fingerprint

Splenic Rupture
Mantle-Cell Lymphoma
Lymphoproliferative Disorders
Splenic Infarction
Lymphocytosis
Disease Susceptibility
Splenomegaly
Peritoneal Cavity
Acute Pain
Vincristine
Splenectomy
Hematologic Neoplasms
Prednisone
Meningitis
Methotrexate
Hematoma
Doxorubicin
Cyclophosphamide
Abdominal Pain
Pneumonia

Keywords

  • Blastic transformation
  • Chronic lymphocytic leukemia
  • Cyclin D1
  • Splenic infarct
  • Splenomegaly

ASJC Scopus subject areas

  • Cancer Research

Cite this

Spontaneous (pathological) splenic rupture in a blastic variant of mantle cell lymphoma : A case report and literature review. / Lunning, Matthew A.; Stetler-Stevenson, Maryalice; Silberstein, Peter T.; Zenger, Vincent; Marti, Gerald E.

In: Clinical lymphoma, Vol. 3, No. 2, 09.2002, p. 117-120.

Research output: Contribution to journalArticle

Lunning, Matthew A. ; Stetler-Stevenson, Maryalice ; Silberstein, Peter T. ; Zenger, Vincent ; Marti, Gerald E. / Spontaneous (pathological) splenic rupture in a blastic variant of mantle cell lymphoma : A case report and literature review. In: Clinical lymphoma. 2002 ; Vol. 3, No. 2. pp. 117-120.
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