Pediatria pre prax 6/2014

An unexpected cause of acute chest pain in adolescent boy

We are presenting the case of a boy admitted to hospital for acute chest pain; the boy has been diagnosed with spontaneous rupture of the spleen. Based on laboratory test results, we anticipated EBV (Epstein-Barr virus) etiology of the boy’s condition, but surprisingly, the histological analysis determined a rare type of non-Hodgkin lymphoma. Spleen rupture belongs among the life-threatening complications of infectious mononucleosis, and the speed of its diagnosis is of key import for the patient’s prognosis quoad vitam. Peripheral T-cell lymphoma is an entirely rare paediatric disease; only a few cases of incidence of such tumor in children has been published as of yet. Please find attached the development and the differential diagnostic nature of this very unique case.

Keywords: splenic rupture, Kehr´s sign, hemoperitoneum, Epstein-Barr virus, infectious mononucleosis, peripheral T-cell lymphoma.