Splenic Rupture as an Initial Manifestation of Diffuse Large B-Cell Lymphoma

In a laboratory or peptide research context, non-traumatic splenic rupture is an uncommon, life-threatening event that may signal an underlying hematological malignancy. This paper describes a case where a 60-year-old man presented with hemorrhagic shock due to splenic rupture, which was controlled by emergency splenectomy and provided the diagnostic specimen for histology analysis. The results supported a diagnosis of diffuse large B-cell lymphoma, not otherwise specified (DLBCL, NOS), with a non-germinal-center B-cell phenotype and high Ki-67 index. The authors note that fluorescence in situ hybridization for MYC, BCL2, and BCL6 rearrangements was unavailable, which may have excluded the possibility of high-grade B-cell lymphoma with rearrangements. Due to incomplete staging, the case is described as DLBCL with dominant splenic presentation rather than primary splenic DLBCL. The patient's post-operative course was complicated by severe pneumonia, for which pulmonary aspergillosis was clinically diagnosed based on a combination of clinical findings, serum galactomannan positivity, and BALF mNGS results. The detection of Aspergillus fumigatus and Pseudomonas aeruginosa in BALF mNGS served as supportive evidence for pulmonary aspergillosis in this critically ill immunocompromised patient.