Splenic rupture in a human immunodeficiency virus-infected patient with primary splenic lymphoma. Splenic rupture presenting as primary malignant lymphoma of the spleen is a rare event. We report such an occurrence in a young man who had a primary B-cell immunoblastic lymphoma of the spleen and was found to be HIV-positive. We suggest that serologic tests for HIV should be performed in unusual cases of malignant lymphoma. 