Abstract
A 73-year-old man, without history of trauma, was referred to our hospital with the diagnosis of acute abdomen. He had a pain in the left hypochondriac region. On the abdominal examination, there was tenderness in the region. Enhanced abdominal computed tomography (CT) revealed fluid collection with high density around the liver and an enlarged spleen. Under the diagnosis of non-traumatic rupture of the spleen, an emergency operation was performed. Because malignant lymphoma and other malignant tumors were suspected, a splenectomy was chosen. The intraoperative pathological evaluation was malignant lymphoma. A peripheral-blood smear showed atypical lymphocytes. His condition progressively worsened from postoperative day nine. Acute exacerbation of the malignant lymphoma was suspected. Soluble prednisone was started so his condition showed a tendency to improve. Pathological diagnosis was CD20 positive diffuse large B-cell lymphoma. A total of eight courses of R-CHOP therapy were given. No evidence of recrudescence of malignant lymphoma was evident at 14 months postoperatively. We reported a case of splenic rupture due to malignant lymphoma where splenectomy was an effective treatment option for diagnosis and treatment.
