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Lymphoreticular malignancy presenting as fulminant hepatic disease

T V Colby, D R LaBrecque

    Gastroenterology
    |February 1, 1982
    PubMed
    Summary

    Fulminant hepatic disease due to lymphoreticular infiltration is rare and often misdiagnosed. Autopsies revealed malignant histiocytosis as the cause of severe liver illness in four patients.

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    Area of Science:

    • Hepatology
    • Oncology
    • Pathology

    Background:

    • Fulminant hepatic disease (FHD) presents a diagnostic challenge, with diverse etiologies.
    • Lymphoreticular infiltration of the liver can lead to severe liver dysfunction.

    Observation:

    • Four cases of FHD were analyzed, all resulting in patient mortality within weeks.
    • Clinical diagnoses varied, including viral, alcoholic, and drug-induced hepatitis, masking the underlying malignancy.
    • Malignancy was suspected pre-mortem in only one of the four patients.

    Findings:

    • Autopsies confirmed malignant histiocytosis in three patients and a primitive lymphoreticular malignancy in the fourth.
    • Histological liver infiltration was mild, contrasting sharply with the severe clinical presentation.
    • Necrotic foci in the liver correlated with elevated serum glutamic oxaloacetic transaminase (SGOT) levels in two patients.

    Implications:

    • This study highlights the importance of considering lymphoreticular malignancies in unexplained FHD.
    • Early diagnosis and recognition of malignant histiocytosis are crucial for appropriate management.
    • Further research is needed to elucidate the pathogenesis of liver infiltration in these malignancies.

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