title: Acute liver failure due to natural killer-like T-cell leukemia/lymphoma: a case report and review of the literature.
abstract: Acute liver failure (ALF) is a medical emergency requiring immediate evaluation for liver transplantation. We describe an unusual case of a patient who presented with ascites, jaundice, and encephalopathy and was found to have ALF due to natural killer (NK)-like T cell leukemia/lymphoma. The key immunophenotype was CD2+, CD3+, CD7+, CD56+. This diagnosis, which was based on findings in the peripheral blood and ascitic fluid, was confirmed with liver biopsy, and was a contraindication to liver transplantation. A review of the literature shows that hematologic malignancies are an uncommon cause of fulminant hepatic failure, and that NK-like T-cell leukemia/lymphoma is a relatively recently recognized entity which is characteristically CD3+ and CD56+. This case demonstrates that liver biopsy is essential in diagnosing unusual causes of acute liver failure, and that infiltration of the liver with NK-like T-cell lymphoma/leukemia can cause acute liver failure.
authors.affiliation: University of North Carolina School of Medicine, Division of Gastroenterology and Hepatology, CB#7080, Bioinformatics Bldg, Rm 1140, 130 Mason Farm Rd, Chapel Hill, NC 27599-7080, United States. edellon@unch.unc.edu
authors.forename: Evan S
authors.initials: ES
authors.lastname: Dellon
authors.forename: Shannon R
authors.initials: SR
authors.lastname: Morris
authors.forename: Wozhan
authors.initials: W
authors.lastname: Tang
authors.forename: Cherie H
authors.initials: CH
authors.lastname: Dunphy
authors.forename: Mark W
authors.initials: MW
authors.lastname: Russo
mesh_terms: D000075202:Contraindications; D017809:Fatal Outcome; D006801:Humans; D016130:Immunophenotyping; D007694:Killer Cells, Natural; D015459:Leukemia-Lymphoma, Adult T-Cell / Q000150:complications* / Q000175:diagnosis; D017114:Liver Failure, Acute / Q000209:etiology*; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged