A Case of B-Cell Chronic Lymphocytic Leukemia with Spontaneous Splenic Rupture

Masakazu Fujii, Yoshikazu Okazaki, Masaki Ohnaru¹⁾ and Kimikazu Hamano²⁾

Department of Surgery and Department of Pharmacy¹⁾, Ehime Rosai Hospital
First Department of Surgery, Yamaguchi University School of Medicine²⁾

An 83-year-old man with B-cell chronic lymphocytic leukemia diagnosed 13 years earlier but not treated because thrombocythemia was mild and developing splenomegaly 4 years later, was admitted for sudden-onset left lateral abdominal pain with no history of trauma in October 2008. Abdominal computed tomography showed bleeding in the abdominal cavity with splenic rupture, necessitating splenectomy. We found a huge 1950 g 18×12×7.5 cm splenomegaly and bloody ascites. Pathological examination showed the invasion of B lymphocytes that were CD-20 positive in the red pulp. The man had no complications except for hyperleukocytosis caused by chronic lymphocytic leukemia. He was discharged on post operative day 12. He still is not administered medication and his platelet value remains within the normal range.

Key words
chronic lymphocytic leukemia, splenic rupture, abdominal cavity bleeding

Reprint requests
Masakazu Fujii Department of Surgery, Ehime Rosai Hospital
13-27 Minamikomatsubarachou, Niihama, 792-0863 JAPAN

Accepted
July 22, 2009

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