慢性髓性白血病自发性脾破裂的尸检报告:罕见病例报告

Jayeshkumar Kanani , Mohammed Iliyas Sheikh
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摘要

慢性髓性白血病(CML)是一种罕见的血液系统恶性肿瘤,其特点是多能造血干细胞的基因发生改变,导致 BCR-ABL1 融合基因。虽然 CML 通常会经历三个阶段,其中慢性阶段最为常见,但自发性脾破裂(SSR)仍是一种极为罕见的并发症。及时识别和干预是优化自发性脾破裂患者预后的关键。我们报告了一例 43 岁男性慢性骨髓性白血病患者的病例,该患者被诊断为慢性期慢性骨髓性白血病,在门诊就诊时突然出现腹痛并接受了镇痛剂治疗,最终导致意外猝死。尸检显示,该患者因自发性脾破裂导致广泛的腹腔积血。该病例凸显了自发性脾破裂在 CML 患者中的罕见性和临床意义。继续报告和分析 SSR 病例对于加深我们的理解和改善患者预后至关重要。让患者了解 SSR 的潜在风险和及时报告症状的重要性,可以让他们及时就医,从而减少不良后果。我们有必要进一步研究 CML 中 SSR 的病理生理机制,为临床管理策略提供依据并改善患者护理。
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An autopsy presentation of spontaneous splenic rupture in chronic myeloid leukemia: A rare case report

Chronic myeloid leukemia (CML) is a rare hematologic malignancy characterized by genetic alterations in pluripotential hematopoietic stem cells that result in the BCR-ABL1 fusion gene. Although CML typically progresses through three phases, with the chronic phase being the most common, spontaneous splenic rupture (SSR) remains an exceedingly rare complication. Prompt recognition and intervention are crucial for optimizing patient outcomes in cases of SSR. We present the case of a 43-year-old male diagnosed with chronic-phase CML who experienced sudden-onset abdominal pain and was treated with analgesics during an OPD visit, leading to sudden and unexpected death. Postmortem examination revealed extensive hemoperitoneum secondary to spontaneous splenic rupture. This case highlights the rarity and clinical significance of SSR in patients with CML. Continued reporting and analysis of SSR cases is essential for advancing our understanding and improving patient outcomes. Educating patients about the potential risks of SSR and the importance of prompt reporting of symptoms can empower them to seek timely medical attention, potentially reducing adverse outcomes. Further research into the pathophysiological mechanisms underlying SSR in CML is warranted to inform clinical management strategies and to improve patient care.

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