To the Editor.—Following is a description of a true case of hypersplenism.
Report of a Case.—A 20-year-old woman presented with a painful mass in the left upper quadrant of the abdomen. Ultrasonography disclosed an enlarged spleen. Over the following year the mass enlarged dramatically. The patient denied any history of trauma, mononucleosis, hepatitis, fever, chills, or night sweats. Significant aspects of the physical examination included an absence of hepatomegaly and lymphadenopathy. Abdominal examination demonstrated a hard, nontender, fixed, protuberant mass in the left upper abdominal quadrant that extended laterally to the right midclavicular line and inferiorly beyond the umbilicus. Laboratory values were as follows: hemoglobin level, 10.9 g/dL (109 g/L); hematocrit, 35.9% (0.36); white blood cell count, 3.6×103/mm3 (3.6×109/L); and platelet count, 134 000/mm3 (134 × 109/L). An abdominal computed tomographic (CT) scan disclosed a greatly enlarged spleen with a