Work

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

Year: 2025

Type: article

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. LEARNING POINTS: Lymphoma presenting as fulminant hepatitis is rare and frequently fatal.Malignant infiltration of the liver should be suspected in cases of acute liver failure, particularly when no clear aetiology is present, and liver biopsy should be performed promptly.The internist should be aware of lymphoma as a potential cause of type B, non-hypoxemic lactic acidosis.

Source: European Journal of Case Reports in Internal Medicine

DOI: 10.12890/2025_005236

Authors: Catarina Melita, Joaquim Tinoco, Rita Theias Manso, Liliana Antunes, Mónica Palma Anselmo, Paulo Telles de Freitas

Institution: Hospital Prof. Dr. Fernando Fonseca

Language: English

Topic: Lymphoma Diagnosis and Treatment

Subfield: Pathology and Forensic Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $323