title: Fulminant liver failure induced by hepatosplenic alphabeta T-cell lymphoma.
abstract: Since survival rates of fulminant liver failure are low, early consideration of liver transplantation in patients developing hepatic encephalopathy due to progressive liver failure is mandatory. Rapid diagnostic work-up is necessary to identify the underlying disease and to rule out contraindications to liver transplantation. We report the case of a 35-year-old patient presenting with fulminant hepatitis and a four-week history of biopsy-proven autoimmune hepatitis. Despite high-dose steroid-treatment liver function progressively worsened and hepatic encephalopathy rapidly developed. Histopathologic evaluation of a liver biopsy specimen revealed necrotizing hepatitis and rare atypical lymphocytes. Surgical biopsy specimens confirmed the suspicion of an aggressive hepatosplenic alphabeta T-cell lymphoma which represents a contraindication to liver transplantation.
authors.affiliation: Department of Gastroentrology, University Hospital of Cologne, Joseph-Stelzmann-Str. 9, 50 931 Cologne.
authors.forename: C
authors.initials: C
authors.lastname: Petersen-Benz
authors.forename: N
authors.initials: N
authors.lastname: Hoffmann
authors.forename: T
authors.initials: T
authors.lastname: Beckurts
authors.forename: T
authors.initials: T
authors.lastname: Goeser
authors.forename: H-M
authors.initials: HM
authors.lastname: Steffen
authors.forename: V
authors.initials: V
authors.lastname: Dries
mesh_terms: D000328:Adult; D001706:Biopsy; D006501:Hepatic Encephalopathy / Q000209:etiology / Q000401:mortality; D006505:Hepatitis / Q000473:pathology; D019693:Hepatitis, Autoimmune / Q000150:complications / Q000473:pathology; D006801:Humans; D007150:Immunohistochemistry; D007813:Laparotomy; D008099:Liver / Q000473:pathology; D017093:Liver Failure / Q000209:etiology* / Q000401:mortality; D008113:Liver Neoplasms / Q000150:complications* / Q000175:diagnosis / Q000473:pathology; D016399:Lymphoma, T-Cell / Q000150:complications* / Q000175:diagnosis / Q000473:pathology; D008297:Male; D013154:Spleen / Q000473:pathology; D013160:Splenic Neoplasms / Q000150:complications* / Q000175:diagnosis / Q000473:pathology