Pathologic-spontaneous-rupture of the spleen as a presenting sign of splenic T-cell lymphoma - Case report with review

A 39 year-old man presented for surgery with epigastric pain, tachycardia, hypotension and a progressive decrease of hemoglobin due to blood loss. Imm ediate abdominal ultrasonography followed by prompt paracentesis revealed m assive intraperitoneal hemorrhage. During emergency laparotomy, a linear, a ctively bleeding rupture of an enlarged spleen was found and splenectomy wa s performed. The patient survived and the post-operative course was unevent ful. Histopathology of the spleen as well as bone marrow biopsy confirmed t he diagnosis of T-Cell lymphoma. Chemotherapy was initiated 3 weeks after s urgery. To the best of our knowledge, this is the first reported case of previously undiagnosed T-Cell lymphoma presenting as pathologic rupture of the spleen .