{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T14:54:44Z","timestamp":1772204084360,"version":"3.50.1"},"reference-count":52,"publisher":"BMJ","issue":"12","license":[{"start":{"date-parts":[[2023,12,1]],"date-time":"2023-12-01T00:00:00Z","timestamp":1701388800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2023,11,10]]},"published-print":{"date-parts":[[2023,12]]},"abstract":"<jats:p>A patient was admitted to hospital with splenic rupture, four 4 days after colonoscopy was performed following one month\u2019s intermittent and aggravating abdominal pain. During recovery from splenectomy, the patient developed sudden tachycardic and tachypnoea. A blood sample revealed a very low blood glucose, high lactate and acidaemia.<\/jats:p>\n               <jats:p>The patient required high-dose continuous intravenous glucose, while the lactate remained elevated. Decreasing consciousness with signs of acute liver failure necessitated transfer to an advanced intensive care unit. The patient\u2019s clinical status rapidly deteriorated despite therapeutic intervention. The patient died of multiorgan failure eleven days post-splenectomy. Based on the pathology of the spleen and a post-mortem liver specimen, the patient was diagnosed with a primary extra-nodal B-cell hepatosplenic lymphoma (BCHSL) \u2013 an extremely rare form of non-Hodgkin lymphomanon.<\/jats:p>\n               <jats:p>Splenic rupture followed by lactic acidosis and hypoglycaemia should lead to suspicion of a cancer-mediated Warburg effect, and prompt urgent chemotherapy.<\/jats:p>","DOI":"10.1136\/bcr-2023-257154","type":"journal-article","created":{"date-parts":[[2023,12,1]],"date-time":"2023-12-01T12:21:04Z","timestamp":1701433264000},"page":"e257154","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":6,"title":["B-cell hepatosplenic lymphoma presenting in adult patient after spontaneous splenic rupture followed by severe persistent hypoglycaemia: type B lactic acidosis and acute liver failure"],"prefix":"10.1136","volume":"16","author":[{"given":"Mette","family":"Moen","sequence":"first","affiliation":[{"name":"Department of Anaesthesiology, Regional Hospital Horsens, Horsens, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephen","family":"Hamilton-Dutoit","sequence":"additional","affiliation":[{"name":"Department of Pathology, Aarhus University Hospital, Aarhus N, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Torben","family":"Steiniche","sequence":"additional","affiliation":[{"name":"Department of Pathology, Aarhus University Hospital, Aarhus N, Denmark"},{"name":"Department of Clinical Medicine, Aarhus University, Aarhus N, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2888-1842","authenticated-orcid":false,"given":"Martin Faurholdt","family":"Gude","sequence":"additional","affiliation":[{"name":"Prehospital Emergency Medical Services, Research and Development, Central Denmark Region, Aarhus N, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2023,12,1]]},"reference":[{"key":"2025082713202635000_16.12.e257154.1","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(20011101)92:9<2237::AID-CNCR1569>3.0.CO;2-9"},{"key":"2025082713202635000_16.12.e257154.2","doi-asserted-by":"crossref","DOI":"10.14814\/phy2.14737","article-title":"Burkitt lymphoma and lactic acidosis: a case report and review of the literature","volume":"9","author":"Looyens","year":"2021","journal-title":"Physiol Rep"},{"key":"2025082713202635000_16.12.e257154.3","doi-asserted-by":"crossref","DOI":"10.1038\/bcj.2016.104","article-title":"Uncovering molecular abnormalities leading to the warburg effect in primary refractory diffuse large B-cell lymphoma","volume":"6","author":"Soleja","year":"2016","journal-title":"Blood Cancer J"},{"key":"2025082713202635000_16.12.e257154.4","doi-asserted-by":"crossref","unstructured":"Goyal I , Ogbuah C , Chaudhuri A , et al . 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