Acute lymphoblastic leukaemia (ALL) is rarely seen in pregnancy. Massive hepatosplenomegaly as a presentation of ALL has not been
described previously in any patient population. A 30-year-old pregnant woman presented at 16 weeks’ gestation with epistaxis, jaundice,
diffuse abdominal pain and distension, massive hepatosplenomegaly and peripheral oedema. On the basis of blood tests, bone marrow
biopsy and imaging, a diagnosis of ALL complicated by massive hepatosplenomegaly with splenic infarctions was made. The patient was
referred to oncology for appropriate chemotherapy.