Infiltration of the liver by a lymphoproliferative disorder can rarely result in acute liver failure. This is associated with a poor prognosis.
Hematologic malignancies associated with acute liver failure include:
(1) B-cell or T-cell CLL
(2) acute leukemia
(3) malignant lymphoma
Diagnostic features:
(1) onset of acute hepatic failure (may be presenting manifestation)
(2) presence of hematologic malignancy
(3) presence of a significant hepatic infiltration by the hematologic malignancy
(4) exclusion of other causes (infectious, toxic, etc)
Risk factors:
(1) hematologic disease progression (chronic to acute leukemia, Richter syndrome)
(2) hepatic outflow obstruction
Some patients improve following appropriate chemotherapy while others continue to progress.
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Specialty: Gastroenterology
