Introduction. Small lymphocytic lymphoma/chronic lymphocytic leukemia (SLL/CLL) is an indolent lymphoproliferative disorder characterized by accumulation of mature but dysfunctional B lymphocytes. Aortic complications have been occasionally reported in lymphoma, most often in aggressive subtypes, while they are extremely rare in SLL/CLL. The aim of this report was to present a case of recently developed ruptured abdominal aortic aneurysm in a patient with SLL and its successful hybrid endovascular management. Case outline. A 58-year-old male with SLL/CLL presented with lower back and right flank pain. Initial CT demonstrated marked progression of lymphadenopathy and interval enlargement of the infrarenal aortic diameter compared to prior imaging, remaining below the aneurysmal threshold. Due to persistent symptoms and elevated inflammatory markers, further imaging was performed. MRI of the lumbosacral spine and subsequent CT angiography revealed a newly developed saccular aneurysm of the infrarenal abdominal aorta with retroperitoneal hematoma and surrounding lymph node conglomerates. The patient underwent urgent endovascular repair using an aorto-uni-iliac stent graft with contralateral iliac occlusion, combined with femoro-femoral crossover bypass. Postprocedural imaging confirmed successful exclusion of the lesion without endoleak. Conclusion. This case highlights a rare vascular complication of SLL/CLL and suggests a possible role of lymphomatous infiltration and inflammation in aortic wall weakening. Hybrid endovascular treatment represents an effective therapeutic option.
Till et al. (Thu,) studied this question.