Yamazaki Shun, Watanabe Yusuke, Takahashi Kazuya, Tominaga Kentaro, Ikarashi Satoshi, Yokoo Takeshi, Kamimura Hiroteru, Tsuchiya Atsunori, Terai Shuji
Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Japan.
Division of Preemptive Medicine for Digestive Disease and Healthy Active Life, School of Medicine, Niigata University, Japan.
Intern Med. 2025 May 15;64(10):1534-1541. doi: 10.2169/internalmedicine.4450-24. Epub 2024 Oct 11.
Among causes of liver failure, liver failure due to lymphocytic infiltration is rare. Unlike typical liver failure, some cases present with severe lactic acidosis and a poor prognosis. We herein report a case of diffuse large B-cell lymphoma with severe lactic acidosis and liver failure. We further discuss the characteristics of similar cases in the literature, suggesting that intrahepatic infiltration by hematological malignant cells should be considered as a differential diagnosis in the presence of severe lactic acidosis and liver failure. This study underscores the importance of early recognition and serves as a reference for future cases.
在肝衰竭的病因中,淋巴细胞浸润所致的肝衰竭较为罕见。与典型肝衰竭不同,部分病例表现为严重乳酸酸中毒且预后不良。我们在此报告一例伴有严重乳酸酸中毒和肝衰竭的弥漫性大B细胞淋巴瘤病例。我们进一步讨论了文献中类似病例的特征,提示在出现严重乳酸酸中毒和肝衰竭时,应将血液系统恶性细胞的肝内浸润作为鉴别诊断的考虑因素。本研究强调了早期识别的重要性,并为未来病例提供参考。