Chronic myeloid leukemia: Manifesting as spontaneous splenic rupture and terminating in megakaryoblastic transformation

Abstract

We report a case of chronic myeloid leukemia with spontaneous splenic rupture as the initial presenting feature; there was a successful surgical outcome, but this case terminated in megakaryoblastic transformation. Results are reported based on morphological, immunological, cytochemical, ultrastructural, immunocytochemical studies, and in vitro liquid culture studies. The megakaryocytic nature of the blast cells was identified through the demonstration of platelet peroxidase activity by ultrastructural cytochemistry and the presence of platelet and megakaryocyte-specific antigen using monoclonal antibody, as well as the anti-factor VIII antibody by immunocytochemical technique.

Clinicopathological features of acute megakaryoblastic leukaemia: Relationship between fibrosis and platelet‐derived growth factor

“…Previous studies reported that AMGL includes not only idiopathic cases, but also the so‐called secondary AMGL, such as those that progress from MDS, CML, ET and CMF . In this study, six cases progressed from MDS, one case from CML, one case from ET and one case from CMF.…”

Chronic Myeloid Leukaemia Presenting as Traumatic Haemoperitoneum and Duodenal Injury

“…5 Interestingly, in all three cases, splenic rupture was the first presenting feature. A 35-year-old man died 3 while the other two patients sur vived after surgery. 4,5 The origin of bleeding in the peritoneum was obscure in our case, but the grossly enlarged spleen would be the most likely source.…”

“…2 Rupture of a parenchymal or g an with resultant haemoperitoneum is exceedingly rare. Three cases of spontaneous rupture of the spleen in patients with CML has been reported, [3][4][5] including a 10-year-old boy. 5 Interestingly, in all three cases, splenic rupture was the first presenting feature.…”