Abstract
This paper describes a case of primary myelofibrosis (PMF) associated with splenic infarction which was treated by splenectomy. A 58-year-old man who had been diagnosed as PMF 1.5 years before was admitted to the hospital because of splenomegaly, left hypochondralgia, high fever and marked decrease in peripheral platelet (1-2×104/μl). Abdominal CT scan and RI scintigraphy indicated multiple splenic infarction. Splenectomy was performed because his symptoms were aggravated. After the operation hypochondralgia and fever disappeared and the patient was discharged from the hospital on 30th postoperative day. For severe thrombocytopenia, administration of “platelet concentrate” during perioperative period contributed to preventing hemorrhagic diathesis, and the huge spleen 2330g in weight could be easily resected with only 300g of intraoperative bleeding without complications. Some authors have reported that splenectomy in PMF patients is much riskier than that in other diseases. We suppose that splenectomy in PMF patients may be recommended not to improve hematological findings, but to relieve severe symptoms due to splenic infarction like this case.
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