Diffuse large B cell lymphoma presenting with acute liver failure: a case report

Abstract

Acute liver failure (ALF) is an uncommon disease, and between its etiologies, malignant infiltration is quite rare and it carries high mortality. When ALF due to malignant infiltration occurs, the hematological malignancies are the most common including: Hodgkin lymphoma, non-Hodgkin Lymphoma (NHL) and acute and chronic leukemias. Hematologic malignancies often involve the liver, the NHL that most often involved the liver is the diffuse large B cell lymphoma accounting for 51% of all B-NHL cases, but they rarely present as ALF, thus is not commonly taken into account as an etiology of liver failure and is likely underrecognized. Here, we describe an unusual case of a patient diagnosed with a diffuse large B cell lymphoma, who developed an acute liver failure due to lymphoma liver infiltration, after the first chemotherapy cycle, that was not diagnosed at the initial staging. Finally the patient turns unresponsive to chemotherapy and die. We emphasize the importance of the early diagnosis by liver biopsy and the early start of chemotherapy treatment as the only hope of remission.