PMID- 38050395
OWN - NLM
STAT- MEDLINE
DCOM- 20231206
LR  - 20231217
IS  - 1757-790X (Electronic)
IS  - 1757-790X (Linking)
VI  - 16
IP  - 12
DP  - 2023 Dec 1
TI  - 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.
LID - 10.1136/bcr-2023-257154 [doi]
LID - e257154
AB  - A patient was admitted to hospital with splenic rupture, four 4 days after 
      colonoscopy was performed following one month's 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.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's 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) - an extremely rare form of non-Hodgkin 
      lymphomanon.Splenic rupture followed by lactic acidosis and hypoglycaemia should 
      lead to suspicion of a cancer-mediated Warburg effect, and prompt urgent 
      chemotherapy.
CI  - (c) BMJ Publishing Group Limited 2023. Re-use permitted under CC BY-NC. No 
      commercial re-use. See rights and permissions. Published by BMJ.
FAU - Moen, Mette
AU  - Moen M
AD  - Department of Anaesthesiology, Regional Hospital Horsens, Horsens, Denmark.
FAU - Hamilton-Dutoit, Stephen
AU  - Hamilton-Dutoit S
AD  - Department of Pathology, Aarhus University Hospital, Aarhus N, Denmark.
FAU - Steiniche, Torben
AU  - Steiniche T
AD  - Department of Pathology, Aarhus University Hospital, Aarhus N, Denmark.
AD  - Department of Clinical Medicine, Aarhus University, Aarhus N, Denmark.
FAU - Gude, Martin Faurholdt
AU  - Gude MF
AUID- ORCID: 0000-0003-2888-1842
AD  - Prehospital Emergency Medical Services, Research and Development, Central Denmark 
      Region, Aarhus N, Denmark gude@dadlnet.dk.
LA  - eng
PT  - Case Reports
PT  - Journal Article
DEP - 20231201
PL  - England
TA  - BMJ Case Rep
JT  - BMJ case reports
JID - 101526291
RN  - 33X04XA5AT (Lactic Acid)
SB  - IM
MH  - Humans
MH  - Adult
MH  - *Acidosis, Lactic/etiology
MH  - *Splenic Rupture/etiology/surgery
MH  - *Liver Failure, Acute
MH  - *Lymphoma, Non-Hodgkin
MH  - *Hypoglycemia/etiology
MH  - Lactic Acid
MH  - Rupture, Spontaneous
PMC - PMC10693868
OTO - NOTNLM
OT  - Haematology (incl blood transfusion)
OT  - Intensive care
OT  - Pathology
OT  - the Warburg effect
COIS- Competing interests: None declared.
EDAT- 2023/12/05 12:42
MHDA- 2023/12/06 06:42
PMCR- 2023/12/01
CRDT- 2023/12/05 03:42
PHST- 2023/12/06 06:42 [medline]
PHST- 2023/12/05 12:42 [pubmed]
PHST- 2023/12/05 03:42 [entrez]
PHST- 2023/12/01 00:00 [pmc-release]
AID - 16/12/e257154 [pii]
AID - bcr-2023-257154 [pii]
AID - 10.1136/bcr-2023-257154 [doi]
PST - epublish
SO  - BMJ Case Rep. 2023 Dec 1;16(12):e257154. doi: 10.1136/bcr-2023-257154.