Splenic Infarct as the Presenting Manifestation of Essential Thrombocythemia

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Figure.
(A) Peripheral blood smear (Leishman stain, magnification ×100) shows increased platelets and platelet clumps. (B) Bone marrow aspirate (Giemsa stain, magnification ×40) shows cellular marrow with megakaryocytes cluster (inset: hyperlobated megakaryocyte). (C) Bone marrow biopsy shows increased number of megakaryocytes with hyperlobated nuclei (hematoxylin and eosin stain [H&E], magnification ×40). (D) Photograph of resected spleen with pale cut surface. (E) Photomicrograph of spleen shows infarcted areas (H&E, magnification ×40).

Table.

Cases of Essential Thrombocythemia With Splenic Infarction

Study	Age/Sex	Symptoms	Platelet count, × 10⁹/L
Yamaguchi et al, 1985⁸	64/M	Fever, left abdominal pain	584
Aoyama et al, 1988⁹	48/M	Left back pain	927
Tohyama and Haruhiko, 1996¹⁰	68/F	Epigastric pain	856
Oki et al, 2008¹¹	65/F	Lower abdominal pain, vomiting, diarrhea	1,665
Bachmeyer and Elalamy, 2011¹²	64/F	Left hypochondrial pain radiating to back	540
Picón-Coronel et al, 2011¹³	22/M	Right sided abdominal pain (cholecystitis)	2,060
Kim et al, 2012¹⁴	46/M	Splenic infarctions, myocardial infarction, cerebral infarction	>600
Yuan et al, 2018³	63/F	Numbness and weakness in right extremities	448
Yoshida et al, 2019⁷	31/M	Left hypochondrial pain	436
Present case, 2022	34/F	Left upper abdominal pain, vomiting	970