case_images: PMC11759071_01
case_images: CT Abdomen/Pelvis showing massive splenomegaly with subcapsular rounded lesion measuring 2.4 x 1.6 cm in the anterior upper pole of the spleen concerning for intraparenchymal hemorrhage.
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case_images: PMC11759071_01_jchim-15-01-054f1.jpg
case_images: f1-jchim-15-01-054
case_images: Repeat CT angiogram of the abdomen and pelvis showed splenomegaly, wedge-shaped areas of hypo-enhancement concerning for splenic infarct or laceration, as well as enlarging hemoperitoneum (Fig. 1).
case_images: White blood cell (WBC) trend throughout the admission.
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case_images: PMC11759071_01_jchim-15-01-054f2.jpg
case_images: f2-jchim-15-01-054
case_images: While preadmission laboratory values were not present, labs on admission were significant for a leukocytosis of 170 K/mm3 which then rose to 230 K/mm3 over the course of one day with blasts present (Fig. 2).
case_images: Peripheral smear under microscopy showing leukocytosis with left shift that included myelocytes, promyelocytes and less than 5 % myeloblasts consistent with CML in chronic phase.
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case_images: PMC11759071_01_jchim-15-01-054f3.jpg
case_images: f3-jchim-15-01-054
case_images: It showed leukocytosis with left shift that included myelocytes, promyelocytes, a few myeoblasts (less than 5 %), and a slight increase in basophils (Fig. 3).