A case of mycosis fungoides in which pathologic rupture of the spleen led to intraperitoneal hemorrhage and death is described. To our knowledge, splenic rupture has not been reported previously as a cause of death in mycosis fungoides. Immunologic studies demonstrated that the neoplastic cell was a suppressor/cytotoxic T-cell. In most cases of mycosis fungoides or the Sézary syndrome, the neoplastic cell has been a helper/inducer T-cell. This case was very aggressive clinically with prominent visceral involvement and suggests that mycosis fungoides may be clinically diverse as well as immunologically heterogeneous.
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