Spontaneous splenic rupture in an acute leukemia patient with splenic tuberculosis: A case report

Zhang,Yue; Zhang,Juan; Chen,Tingting; Zeng,Hui; Zhao,Bing; Zhang,Yong; Zhou,Xiaohuan; Han,Wei; Hu,Yanping; Liu,Fengge; Shan,Zhijuan; Gao,Weifeng; Zhou,Hebing

doi:10.3892/mco.2016.1120

Spontaneous splenic rupture in an acute leukemia patient with splenic tuberculosis: A case report

Authors:
- Yue Zhang
- Juan Zhang
- Tingting Chen
- Hui Zeng
- Bing Zhao
- Yong Zhang
- Xiaohuan Zhou
- Wei Han
- Yanping Hu
- Fengge Liu
- Zhijuan Shan
- Weifeng Gao
- Hebing Zhou
View Affiliations

Affiliations: Department of Hematology, Luhe Hospital, Capital Medical University, Beijing 101149, P.R. China, Department of General Surgery, Luhe Hospital, Capital Medical University, Beijing 101149, P.R. China, Department of Pathology, Luhe Hospital, Capital Medical University, Beijing 101149, P.R. China
Published online on: December 28, 2016 https://doi.org/10.3892/mco.2016.1120
Pages: 209-213

Metrics: Total Views: 0 (Spandidos Publications: | PMC Statistics: )

Metrics: Total PDF Downloads: 0 (Spandidos Publications: | PMC Statistics: )

Cited By (CrossRef): 0 citations Loading Articles...

Abstract

Spontaneous splenic rupture, also referred to as atraumatic splenic rupture, is a rare but life‑threatening emergency condition. Without timely diagnosis and treatment, the mortality rate of splenic rupture approaches 100%. The etiology of atraumatic splenic rupture varies; it is reportedly associated with neoplasms or splenic infection, but is rarely encountered in patients with both conditions. We herein report the case of a 58‑year‑old male patient with acute myeloid leukemia (AML) complicated by splenic tuberculosis (TB), who presented with spontaneous rupture of the spleen. Pathological examination of the resected spleen revealed multifocal granulomatosis with caseous necrosis. However, with timely diagnosis and surgical intervention, the patient recovered successfully and is currently on consolidation therapy. To the best of our knowledge, this is the first case of spontaneous splenic rupture in AML with splenic TB. The relevant literature on spontaneous splenic rupture was also reviewed and the potential etiology and treatment were discussed.

View Figures

View References

1	Han JS, Oh SY, Kim SH, Kwon HC, Hong SH, Han JY, Park KJ and Kim HJ: A case of pathologic splenic rupture as the initial manifestation of acute myeloid leukemia M2. Yonsei Med J. 51:138–140. 2010. View Article : Google Scholar : PubMed/NCBI
2	Zimmer BM, Berdel WE, Ludwig WD, Notter M, Reufi B and Thiel E: Fatal spleen rupture during induction chemotherapy with rh GM-CSF priming for acute monocytic leukemia. Clinical case report and in vitro studies. Leuk Res. 17:277–283. 1993. View Article : Google Scholar : PubMed/NCBI
3	Kasper C, Jones L, Fujita Y, Morgenstern GR, Scarffe JH and Chang J: Splenic rupture in a patient with acute myeloid leukemia undergoing peripheral blood stem cell transplantation. Ann Hematol. 78:91–92. 1999. View Article : Google Scholar : PubMed/NCBI
4	Hernández R, del Cañizo MC, López C, González MI, Vázquez ML, Caballero MD and San Miguel JF: Pathologic rupture of the spleen during induction with ATRA in a patient with acute promyelocytic leukemia. Med Oncol. 17:337–339. 2000. View Article : Google Scholar : PubMed/NCBI
5	Tan A, Ziari M, Salman H, Ortega W and Cortese C: Spontaneous rupture of the spleen in the presentation of acute myeloid leukemia. J Clin Oncol. 25:5519–5520. 2007. View Article : Google Scholar : PubMed/NCBI
6	Singhal V, Kuiper J, Chavda K and Kashmer D: Spontaneous splenic rupture as first manifestation of acute myeloid leukemia: Case report and review of literature. J Clin Oncol. 29:e576–e578. 2011. View Article : Google Scholar : PubMed/NCBI
7	Zeidan AM, Mitchell M, Khatri R, Itani D, Boikos S, Bose S, Lipsett P, Efron D, King KE, Gerber J and DeZern A: Spontaneous splenic rupture during induction chemotherapy for acute myeloid leukemia. Leuk Lymphoma. 55:209–212. 2014. View Article : Google Scholar : PubMed/NCBI
8	Renzulli P, Hostettler A, Schoepfer AM, Gloor B and Candinas D: Systematic review of atraumatic splenic rupture. Br J Surg. 96:1114–1121. 2009. View Article : Google Scholar : PubMed/NCBI
9	Giagounidis AA, Burk M, Meckenstock G, Koch AJ and Schneider W: Pathologic rupture of the spleen in hematologic malignancies: Two additional cases. Ann Hematol. 73:297–302. 1996. View Article : Google Scholar : PubMed/NCBI
10	Canady MR, Welling RE and Strobel SL: Splenic rupture in leukemia. J Surg Oncol. 41:194–197. 1989. View Article : Google Scholar : PubMed/NCBI
11	Hynes HE, Silverstein MN and Fawcett KJ: Spontaneous rupture of the spleen in acute leukemia. Report of 2 cases. Cancer. 17:1356–1360. 1964. View Article : Google Scholar : PubMed/NCBI
12	Yeo HJ, Lee SY, Ahn E, Kim EJ, Rhu DG, Choi KU, Lee SE, Cho WH, Jeon D and Kim YS: Spontaneous splenic rupture as a paradoxical reaction during treatment for splenic tuberculosis. Tuberc Respir Dis (Seoul). 75:218–221. 2013. View Article : Google Scholar : PubMed/NCBI
13	Safioleas MC, Stamatakos MC, Safioleas CM, Diab AI and Agapitos EB: Co-existence of spontaneous splenic rupture and tuberculosis of the spleen. Saudi Med J. 27:1588–1590. 2006.PubMed/NCBI
14	Gotor MA, Mur M, Guerrero L, Aspiroz C, Romero D and Gimeno E: Tuberculous splenic abscess in an immunocompetent patient. Gastroenterol Hepatol. 18:15–17. 1995.(In Spanish). PubMed/NCBI
15	Pramesh CS, Tamhankar AP, Rege SA and Shah SR: Splenic tuberculosis and HIV-1 infection. Lancet. 359:3532002. View Article : Google Scholar : PubMed/NCBI
16	Dixit R, Arya MK, Panjabi M, Gupta A and Paramez AR: Clinical profile of patients having splenic involvement in tuberculosis. Indian J Tuberc. 57:25–30. 2010.PubMed/NCBI
17	Zhan F, Wang CJ, Lin JZ, Zhong PJ, Qiu WZ, Lin HH, Liu YH and Zhao ZJ: Isolated splenic tuberculosis: A case report. World J Gastrointest Pathophysiol. 1:109–111. 2010. View Article : Google Scholar : PubMed/NCBI
18	Nayyar V, Ramakrishna B, Mathew G, Williams RR and Khanduri P: Response to antituberculous chemotherapy after splenectomy. J Intern Med. 233:81–83. 1993. View Article : Google Scholar : PubMed/NCBI
19	Kwon JC, Kim SH, Park SH, Choi SM, Lee DG, Choi JH, Yoo JH, Kim YJ, Lee S, Kim HJ, et al: Clinical characteristics and the usefulness of the QuantiFERON-TB Gold In-Tube test in hematologic patients with hepatic or splenic lesions. Korean J Intern Med. 28:187–196. 2013. View Article : Google Scholar : PubMed/NCBI
20	Yoshiki Y, Asai T, Ichikawa M, Hangaishi A, Ota S, Imai Y, Takahashi T and Kurokawa M: A case of myeloid sarcoma with correlation to JAK2V617F mutation, complicated by myelofibrosis and secondary acute myeloid leukemia. Intern Med. 50:2649–2652. 2011. View Article : Google Scholar : PubMed/NCBI
21	McMahon B and Stein BL: Thrombotic and bleeding complications in classical myeloproliferative neoplasms. Semin Thromb Hemost. 39:101–111. 2013.PubMed/NCBI
22	Santos FP, Tam CS, Kantarjian H, Cortes J, Thomas D, Pollock R and Verstovsek S: Splenectomy in patients with myeloproliferative neoplasms: Efficacy, complications and impact on survival and transformation. Leuk Lymphoma. 55:121–127. 2014. View Article : Google Scholar : PubMed/NCBI
23	Melikian AL, Kolosova L, Sokolova MA, Kovrigina AM, Silaev MA, Giliazitdinova EA, Gemdzhian ÉG and Karagiulian SR: Role of splenectomy in the treatment of myelofibrosis. Ter Arkh. 85:69–76. 2013.(In Russian). PubMed/NCBI