Splenic rupture associated with aggressive conversion of indolent T-cell prolymphocytic leukemia

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  • 慢性経過後に急速な進行で脾臓破裂をきたしたT細胞前リンパ球性白血病
  • 症例報告 慢性経過後に急速な進行で脾臓破裂をきたしたT細胞前リンパ球性白血病
  • ショウレイ ホウコク マンセイ ケイカ ゴ ニ キュウソク ナ シンコウ デ ヒゾウ ハレツ オ キタシタ Tサイボウ ゼン リンパキュウセイ ハッケツビョウ

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Abstract

A 65-year-old man was diagnosed with leukocytosis in a routine medical examination. Further laboratory examinations showed increased LDH and sIL-2R levels in the serum. There was no evidence of infiltrative lesions or organomegaly. Bone marrow aspiration revealed many atypical small-sized lymphocytes without apparent nucleoli. Flow cytometric analysis of atypical lymphocytes was positive for T-cell markers, and chromosome analysis showed a normal karyotype. He was diagnosed with the small cell variant of T-PLL. Approximately 34 months later, having received no treatment, his cervical lymph nodes increased in size and number, and his white blood cell count, LDH and sIL-2R levels also rapidly increased. He was then admitted to our hospital. Bone marrow aspiration and cervical lymph node biopsy revealed complex chromosome abnormalities including inv(14)(q11;q32). Computed tomography showed swollen lymph nodes all over his body and hepatosplenomegaly. On the fourth hospital day, spontaneous splenic rupture occurred. Transcatheter arterial embolization was unsuccessful and the patient died. We report this case with rare autopsy findings.

Journal

  • Rinsho Ketsueki

    Rinsho Ketsueki 54 (3), 284-289, 2013

    The Japanese Society of Hematology

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