Malignancy can present as acute liver failure – a case report of B-cell lymphoma with acute liver failure as its first presentation

Authors

• Catarina Melita Internal Medicine Department 2, Hospital Prof. Doutor Fernando Fonseca, Amadora, Portugal
• Joaquim Tinoco Surgical Pathology Department, Hospital Prof. Doutor Fernando Fonseca, Amadora, Portugal
• Rita Theias Manso Surgical Pathology Department, Hospital Prof. Doutor Fernando Fonseca, Amadora, Portugal
• Liliana Antunes Intensive Care Department, Hospital Prof. Doutor Fernando Fonseca, Amadora, Portugal
• Mónica Palma Anselmo Intensive Care Department, Hospital Prof. Doutor Fernando Fonseca, Amadora, Portugal
• Paulo Telles de Freitas Intensive Care Department, Hospital Prof. Doutor Fernando Fonseca, Amadora, Portugal

catarina.melita@ulsasi.min-saude.pt

Keywords

Abstract

Malignant infiltration of the liver is a rare cause of acute liver failure and is associated with an exceedingly high mortality rate. We describe the case of an elderly woman presenting with fulminant hepatitis and simultaneous type B lactic acidosis, with near-normal imaging findings, who was later demonstrated to have non-Hodgkin lymphoma. The presence of acute liver failure, hepatomegaly, markedly elevated lactate dehydrogenase and/or lactic acidosis should raise suspicion for lymphoma infiltration of the liver and prompt liver biopsy early in the course of disease. We hope to raise awareness for this uncommon and elusive presentation of lymphoma, in the hope that it will help achieve earlier diagnoses and improvements in patient survival.

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