{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T21:35:06Z","timestamp":1773092106172,"version":"3.50.1"},"reference-count":16,"publisher":"BMJ","issue":"10","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2021,8,22]]},"published-print":{"date-parts":[[2021,10]]},"abstract":"<jats:p>Though rare, atraumatic rupture of the spleen can be a complication in certain leukaemias and lymphomas. We present a unique case of atraumatic rupture of the spleen in a patient with chronic lymphocytic leukaemia. The patient presented to the emergency department with abdominal pain; he had been on ibrutinib therapy but stopped taking the medication abruptly 6\u2009days prior. On evaluation, he was found to have a ruptured spleen with a haemoperitoneum. Pathology of the excised spleen showed infiltration of the spleen with hyperproliferated CD5+ intermediate-to-large cells, consistent with B-cell lymphoma and favouring Richter\u2019s transformation. There are only a few available reports of patients with similar presentations identified in our literature review.<\/jats:p>","DOI":"10.1136\/bcr-2021-242193","type":"journal-article","created":{"date-parts":[[2021,10,20]],"date-time":"2021-10-20T13:12:22Z","timestamp":1634735542000},"page":"e242193","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Unique case of atraumatic splenic rupture in a patient with chronic lymphocytic leukaemia with Richter\u2019s transformation"],"prefix":"10.1136","volume":"14","author":[{"given":"Swetha","family":"Paduri","sequence":"first","affiliation":[{"name":"Internal Medicine, Rosalind Franklin University of Medicine and Science, North Chicago, Illinois, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8443-5463","authenticated-orcid":false,"given":"Nitish Singh","family":"Nandu","sequence":"additional","affiliation":[{"name":"Internal Medicine, Rosalind Franklin University of Medicine and Science, North Chicago, Illinois, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas","family":"Brucker","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory, Anatomic and Clinical Pathologist, Medical Director of Flow Cytometry Laboratory,Medical Director, department of Anatomic Pathology, Department of Pathology and Laboratory Medicine, Clement J. Zablocki VA Medical Center, Milwaukee, Wisconsin, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul","family":"Roach","sequence":"additional","affiliation":[{"name":"General & Oncologic Surgery, Lovell FHCC Department of Surgery, North Chicago, Illinois, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mukta","family":"Pant-Purohit","sequence":"additional","affiliation":[{"name":"Hemtology\/Oncology, Section Chief, Hemtology\/Oncology Captain James A Lovell Federal Health Care Center, Assistant Professor, Rosalind Franklin University, North Chicago, Illinois, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2021,10,20]]},"reference":[{"key":"2025082709341725000_14.10.e242193.1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-227X-12-11"},{"key":"2025082709341725000_14.10.e242193.2","doi-asserted-by":"publisher","DOI":"10.1007\/s002770050245"},{"key":"2025082709341725000_14.10.e242193.3","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.6737"},{"key":"2025082709341725000_14.10.e242193.4","doi-asserted-by":"crossref","first-page":"13","DOI":"10.12659\/AJCR.883739","article-title":"Spontaneous splenic rupture: a rare life-threatening condition; diagnosed early and managed successfully","volume":"14","author":"Weaver","year":"2013","journal-title":"American Journal of Case Reports"},{"key":"2025082709341725000_14.10.e242193.5","doi-asserted-by":"publisher","DOI":"10.1186\/s12885-018-4385-7"},{"key":"2025082709341725000_14.10.e242193.6","doi-asserted-by":"crossref","first-page":"2712","DOI":"10.1080\/10428194.2019.1602268","article-title":"Rapid disease progression following discontinuation of ibrutinib in patients with chronic lymphocytic leukemia treated in routine clinical practice","volume":"60","author":"Hampel","year":"2019","journal-title":"Leuk Lymphoma"},{"key":"2025082709341725000_14.10.e242193.7","doi-asserted-by":"crossref","DOI":"10.1111\/bjh.14845","article-title":"Splenic rupture following temporary cessation of ibrutinib","volume":"179","author":"Dutton","year":"2017","journal-title":"Br J Haematol"},{"key":"2025082709341725000_14.10.e242193.8","unstructured":"Norris FRCPA D . WHO classification of tumours of haematopoietic and lymphoid tissues (4th Edition) - lymphoma classification in the third Millennium. QML pathology newsletter, 2012. Available: http:\/\/www.qml.com.au\/Portals\/0\/PDF\/Newsletters\/QML_NL_4_2012.pdf"},{"key":"2025082709341725000_14.10.e242193.9","doi-asserted-by":"crossref","DOI":"10.1186\/s40248-017-0107-2","article-title":"Second lung malignancy and Richter syndrome in chronic lymphocytic leukemia: case report and literature review","volume":"12","author":"Soussi","year":"2017","journal-title":"Multidiscip Respir Med"},{"key":"2025082709341725000_14.10.e242193.10","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2141.2011.08907.x"},{"key":"2025082709341725000_14.10.e242193.11","doi-asserted-by":"publisher","DOI":"10.3109\/10428190903515192"},{"key":"2025082709341725000_14.10.e242193.12","doi-asserted-by":"crossref","first-page":"1435","DOI":"10.1080\/10428194.2020.1719092","article-title":"Richter's transformation in patients with chronic lymphocytic leukaemia: a nationwide epidemiological study","volume":"61","author":"Ben-Dali","year":"2020","journal-title":"Leuk Lymphoma"},{"key":"2025082709341725000_14.10.e242193.13","doi-asserted-by":"crossref","unstructured":"Thyagarajan B , Alagusundaramoorthy SS , Shah L , et al . Richter\u2019s transformation presenting as splenic rupture after 6 years of complete remission of chronic lymphocytic leukaemia. 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