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Fulminant hepatic failure from primary hepatic lymphoma: successful treatment with orthotopic liver transplantation and chemotherapy. Transplantation 2005 Oct 15;80(7):993-6

Date

10/27/2005

Pubmed ID

16249751

DOI

10.1097/01.tp.0000173999.09381.95

Scopus ID

2-s2.0-27644567174   37 Citations

Abstract

Systemic lymphomas may involve the liver but rarely cause fulminant hepatic failure (FHF). Acute liver failure from primary hepatic lymphoma (PHL) is even less common with most patients succumbing to the sequelae of FHF before the correct diagnosis is made. We report a patient who underwent successful orthotopic liver transplant (OLT) and chemotherapy for FHF secondary to PHL. This previously-well male developed profound coagulopathy and encephalopathy 6 weeks after the onset of jaundice and fatigue. Workup failed to reveal the underlying cause of his liver failure and the patient soon required urgent OLT. Pathologic evaluation of his explanted liver revealed a malignant T-cell rich, large B-cell non-Hodgkin's lymphoma with widespread hepatocellular necrosis. The patient made an excellent clinical recovery and is undergoing CHOP-Rituxan chemotherapy. This scenario demonstrates that lymphoma should be considered in the differential diagnosis of FHF without clear etiology because of the potential for intervention with transplant and chemotherapy.

Author List

Cameron AM, Truty J, Truell J, Lassman C, Zimmerman MA, Kelly BS Jr, Farmer DG, Hiatt JR, Ghobrial R, Busuttil RW

Author

Michael A. Zimmerman MD, FACS Professor in the Surgery department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Combined Modality Therapy
Humans
Liver
Liver Failure, Acute
Liver Neoplasms
Liver Transplantation
Lymphoma, B-Cell
Male
Middle Aged
Treatment Outcome
jenkins-FCD Prod-486 e3098984f26de787f5ecab75090d0a28e7f4f7c0