Peliosis lienalis with atraumatic splenic rupture in a patient with chronic myelomonocytic leukemia: A case report.

Widmer, Lukas Werner; Ardüser, David; Kraus, Rebecca; Gebbers, Jan-Olaf; Villiger, Peter (2021). Peliosis lienalis with atraumatic splenic rupture in a patient with chronic myelomonocytic leukemia: A case report. International journal of surgery case reports, 80, p. 105641. Elsevier 10.1016/j.ijscr.2021.02.027

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INTRODUCTION

Atraumatic splenic rupture is a rare but life-threatening condition which may be associated with hematological malignancies.

PRESENTATION OF CASE

We present the case of a 63-year-old male patient with a history of chronic myelomonocytic leukemia and sarcoidosis under therapy with prednisone, who suffered an atraumatic splenic rupture with hemodynamic instability. He was managed with proximal splenic artery embolization and secondary open splenectomy. On pathology the diagnosis of peliosis lienalis was established.

DISCUSSION

Peliosis is a rare pathological entity, which presents with multiple blood-filled cavities within parenchymatous organs and is of unknown etiology and pathogenesis. In retrospect a rapid increase in splenomegaly and inhomogeneous parenchyma of the spleen on sonography was realized.

CONCLUSION

Sonographic changes in size and parenchyma of the spleen in patients with hematological malignancies might help suspecting peliosis lienalis with impending splenic rupture and could alter clinical management towards a prophylactic splenectomy.

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