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Lymphoreticular malignancy presenting as fulminant hepatic disease

  • Thomas V. Colby
    Correspondence
    Address requests for reprints to: Thomas V. Colby, M.D., Assistant Professor of Pathology, Stanford University School of Medicine, L235, Stanford University Medical Center, Stanford, California 94305.
    Affiliations
    Department of Pathology, Stanford University Medical Center, USA

    Department of Medicine, University of Iowa Medical Center, USA

    The Iowa City Veterans Administration Medical Center, USA
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  • Douglas R. LaBrecque
    Affiliations
    Department of Pathology, Stanford University Medical Center, USA

    Department of Medicine, University of Iowa Medical Center, USA

    The Iowa City Veterans Administration Medical Center, USA
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      Abstract

      Four cases of fulminant hepatic disease caused by lymphoreticular infiltration are described. All 4 patients died within a few weeks and clinical diagnoses included viral hepatitis, alcoholic hepatitis, and drug hepatitis. A diagnosis of malignancy was made prior to autopsy in only 1 of the 4 patients. Autopsies revealed typical malignant histiocytosis in 3 patients and the fourth had a primitive lymphoreticular malignancy with malignant histiocytosis the favored diagnosis. The extent of the liver infiltrate as judged histologically was mild compared with the severe clinical illness. Randomly scattered foci of necrosis associated with the malignant infiltrate were seen in the 2 patients who had marked elevations of serum glutamic oxaloacetic transaminase.

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