Splenic peliosis associated with rupture in a renal transplant patient.

Introduction Peliosis is an uncommon entity consisting of bloodfilled cavities found most frequently in the liver (peliosis hepatis), although its rare occurrence in the spleen has been described. Originally splenic peliosis was considered a histological curiosity with no clinical significance. Recently, however, 2 cases of fatal haemoperitoneum have been reported following rupture of splenic peliotic cysts (Taxy, 1978; Benjamin and Shunk, 1978). The authors report an additional case of splenic peliosis associated with non-fatal rupture in a renal transplant patient. Case report In 1967, a 21-year-old man presented with chronic renal failure due to chronic glomerulonephritis. After initial peritoneal and haemodialysis in hospital, home dialysis was commenced in 1969. A successful cadaver renal transplant was performed in May 1972. Weekly intramuscular injections of 250 mg testosterone were begun in June 1971 for anaemia (6 g/dl) but were stopped after transplantation. He was maintained on immunosuppressive therapy (azathioprine 100 mg and prednisolone 12-5 mg daily) and remained well until October 1974. He then presented with a sudden onset of pain in the left upper abdominal quadrant with radiation to the shoulder. A mass developed in the left upper quadrant and his haemoglobin fell from 14 to 11 g/dl. The clinical impression was that of a ruptured spleen. There had been no history of trauma, and tests for infectious mononucleosis were