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World J Gastroenterol. 2006 Jul 7;12(25):4089-92.

Acute liver failure due to natural killer-like T-cell leukemia/lymphoma: a case report and review of the literature.

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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.


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.

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