Pathologic Rupture of the Spleen as the Presenting Symptom of Primary Splenic Non-Hodgkin Lymphoma
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CASE REPORT
Pathologic Rupture of the Spleen as the Presenting Symptom of Primary Splenic Non-Hodgkin Lymphoma Orestis Ioannidis & Styliani Papaemmanouil & George Paraskevas & Stavros Chatzopoulos & Anastasios Kotronis & Nikolaos Papadimitriou & Athina Konstantara & Apostolos Makrantonakis & Emmanouil Kakoutis
Published online: 26 April 2011 # Springer Science+Business Media, LLC 2011
Abstract Pathologic splenic rupture is defined as the spontaneous rupture of a diseased spleen and is quite rare. It is usually associated with oncologic, infectious, and hematologic diseases and more seldom with other rare causes. Pathologic splenic rupture related to hematologic malignancy seems to be rare with only 136 cases reported from 1861 until 1996 and a few cases thereafter. NonHodgkin lymphoma and acute myeloid leukemia are most frequently reported followed by chronic myeloid leukemia and lymphoblastic acute leukemia. However, even in cases of non-Hodgkin lymphoma, pathologic splenic rupture as the presenting symptom of the disease is rare as is the presence of primary splenic lymphoma. Conservative treatment is not an option, while operative intervention and emergency splenectomy is the only feasible treatment. We present a very rare case of pathologic rupture of primary splenic lymphoma which was the presenting symptom of the disease.
O. Ioannidis (*) : S. Chatzopoulos : A. Kotronis : N. Papadimitriou : A. Konstantara : A. Makrantonakis : E. Kakoutis First Surgical Department, General Regional Hospital ‘George Papanikolaou’, Thessaloniki, Greece e-mail: [email protected] S. Papaemmanouil Department of Pathology, General Regional Hospital ‘George Papanikolaou’, Thessaloniki, Greece G. Paraskevas Department of Anatomy, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
Keywords Non-Hodgkin Lymphoma . Splenectomy . Splenic lymphoma . Splenic rupture . Spontaneous rupture
Introduction Spontaneous splenic rapture is extremely rare and is defined as a rupture occurring in the absence of trauma or excessive effort, the absence of perisplenic adhesions or scarring suggesting previous rupture or trauma, the absence of diseases that could involve the spleen and precipitate rupture and in a spleen with normal gross morphology and histological findings [1, 2]. Only a few cases have been reported in the literature [3]. However, pathologic splenic rupture, which is defined as the spontaneous rupture of a diseased spleen [1, 2], even if quite rare itself, is more commonly reported in the literature and is usually associated with oncologic, infectious, and hematologic diseases and more seldom with other rare causes [1, 3]. Pathologic splenic rupture related to hematologic malignancy seems to be rare with only 136 cases reported from 1861 until 1996 and a few cases thereafter [2]. Non-Hodgkin lymphoma and acute myeloid leukemia are most frequently reported followed by chronic myeloid leukemia and lymphoblastic acute leukemia [3]. However, even in cases of non-Hodgkin lymphoma, pathologic splenic rupture as
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