Pathologic Rupture of the Spleen in Mantle-Cell-Type Non-Hodgkin’s Lymphoma

Tan, Christopher B.; Rajan, Dhyan; Majeed, Sumreen; Ahmed, Shadab; Freedman, Lester; Mustacchia, Paul

doi:10.1155/2012/351275

Cited by 3 publications

(13 citation statements)

References 16 publications

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“…Our patient's splenic rupture occurred closely following induction chemotherapy. Induction chemotherapy, when the disease burden is at its highest, in theory may cause tumor lysis with release of enzymatic content from the cells, resulting in splenic damage and rupture [5]. Our patient was also taking paroxetine, which can impair platelet function.…”

Section: Discussionmentioning

confidence: 99%

“…In the majority of these, the mantle cell lymphoma was the blastoid variant and splenic rupture was the presenting complaint leading to the diagnosis, whereas in our patient, this occurred shortly after the 1 st cycle of chemotherapy. Risk factors generated from case reports include degree of splenic enlargement, older age, male sex, aggressiveness of underlying disease, fungal infection, growth factor usage, particularly granulocyte colony-stimulating factor (G-CSF), and induction chemotherapy [5]. Our patient's splenic rupture occurred closely following induction chemotherapy.…”

Section: Discussionmentioning

confidence: 99%

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Spontaneous Splenic Rupture and Rituximab-Induced Acute Thrombocytopenia in a Patient with High-Risk Mantle Cell Lymphoma

Williams

Chiruka

2019

Case Reports in Hematology

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Mantle cell lymphoma is a relatively rare type of mature B-cell non-Hodgkin’s lymphoma with an incidence of approximately 8 cases per million persons per year. In patients with mantle cell lymphoma, there are rare case reports of the potentially life-threatening consequences of splenic rupture and rituximab-induced acute thrombocytopenia (RIAT) occurring separately, but there are no reports of these occurring in the same patient. Whilst rare, they are important to be aware of as early detection may prevent fatal outcomes.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Spontaneous Splenic Rupture and Rituximab-Induced Acute Thrombocytopenia in a Patient with High-Risk Mantle Cell Lymphoma

Williams

Chiruka

2019

Case Reports in Hematology

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“…While spontaneous splenic rupture in patients with MCL is rare, this unusual complication should be considered in patients presenting with abdominal pain. In MCL, an enlarged spleen accounts for nearly 40% of cases [6,7]. In aggressive forms of MCL, highly proliferative neoplasm can increase tensile forces from within the spleen [6,7].…”

Section: Discussionmentioning

confidence: 99%

“…In MCL, an enlarged spleen accounts for nearly 40% of cases [6,7]. In aggressive forms of MCL, highly proliferative neoplasm can increase tensile forces from within the spleen [6,7]. It has been theorized, that the rate of splenic expansion outpaces the rate of splenic capsule compensation, which creates high sheering tensile forces of the splenic tissue leading to rupture [7].…”

Section: Discussionmentioning

confidence: 99%

Mantle Cell Lymphoma With Non-traumatic Splenic Rupture Requiring Emergency Splenectomy

Plummer¹,

Yglesias²,

Swiger³

et al. 2022

Cureus

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Mantle cell lymphoma (MCL) is a type of non-Hodgkin (B-cell) lymphoma (NHL) with manifestations ranging from indolent to aggressive disease. This type of NHL is predominately found in western countries and affects men more often than women (M:F 2:1). The median age of diagnosis with the disease is around 60 years of age. In this report, the patient is a 68-year-old female who had an atraumatic splenic rupture with no past medical history of trauma. She presented to the emergency department with severe abdominal pain in her left upper quadrant. An emergency splenectomy was executed successfully, and the patient was stabilized. In this case report, we will discuss the pathogenesis, clinical presentation, known clinical treatment, diagnostic testing, and atraumatic splenic rupture.

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“…If spleen size is less than 20 cm, and the patient is without symptoms related to the enlarged spleen such as shortness of breath, early satiety, gastric reflux, walking problems and left upper quadrant pain, no treatment is necessary. We emphasize that an enlarged spleen may cause cytopenia, with the patient at risk for spontaneous rupture and infarction [ 23 , 24 ]; therefore, we recommend that MCL patients with spleen size above 20 cm should undergo treatment.…”

Section: Proposed Clinical Features Of Smcl (Table 1 mentioning

confidence: 99%

Smoldering mantle cell lymphoma

Desai

Zeng

et al. 2017

J Exp Clin Cancer Res

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BackgroundMantle cell lymphoma (MCL) is an aggressive disease, with poor prognosis and a limited survival. However, some patients with indolent MCL can survive beyond 7~10 years. These patients remain largely asymptomatic and can be in observation for a long time without any treatment. The process of “wait and watch” leaves these patients with the potential risk of evolution to classic, aggressive MCL. On the other hand, early treatment for these patients may not impact overall survival but rather affects the quality of life. Therefore, it is essential to clearly identify this type of indolent MCL at the time of diagnosis.ResultsReported findings of indolent presentation of MCL include: lack of B symptoms, normal serum lactic dehydrogenase (LDH) and β2-microglobulin levels (β2M), low MCL-International Prognostic Index (MIPI) score, maximum tumor diameter less than 3 cm, spleen size < 20 cm, positron emission tomography/computerized tomography with the Standard Uptake Value max <6, Ki-67 less than 30%, with some particular immunophenotype, such as CD5 and CD38 negative, markedly increased CD23 positive lymphocytes proportions, high expression of CD200, kappa light chain restriction, without C-myc, TP53 and NOTCH1/2 mutations, non-blastoid/pleomorphic histology, and no tumor growth on reevaluation every 2~3 months (followed for at least 6 months). Imaging evaluation may only be performed in the presence of disease-related symptoms or organ involvement. Meanwhile, if novel nodal or extranodal lesion is found, biopsy is mandatory to exclude lymphoma.Common clinopathological forms of indolent presentations include monoclonal B lymphocytosis with t (11; 14); “indolent leukemic” presentation of MCL with involvement of peripheral blood, bone marrow involvement, splenomegaly, and minimal lymphadenopathies and in situ lymphoma (often found in lymph nodes removed for other reasons, and in gastrointestinal biopsies).ConclusionsConsidering these distinct indolent clinical presentations with particular features in cytology and gene mutational status, we propose to include these MCL clinical presentations under the umbrella of “Smoldering Mantle Cell Lymphoma”.

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Pathologic Rupture of the Spleen in Mantle-Cell-Type Non-Hodgkin’s Lymphoma

Cited by 3 publications

References 16 publications

Spontaneous Splenic Rupture and Rituximab-Induced Acute Thrombocytopenia in a Patient with High-Risk Mantle Cell Lymphoma

Spontaneous Splenic Rupture and Rituximab-Induced Acute Thrombocytopenia in a Patient with High-Risk Mantle Cell Lymphoma

Mantle Cell Lymphoma With Non-traumatic Splenic Rupture Requiring Emergency Splenectomy

Smoldering mantle cell lymphoma

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