Acute liver failure as a rare initial manifestation of peripheral T-cell lymphoma

Figure 1 Contrast-enhanced computed tomography coronal reconstructions. A: An enlarged, heterogenous liver, 20 cm in the craniocaudad dimension; B: There are also multiple, subcapsular peripheral defects that lack enhancement in an enlarged spleen (arrow) representing splenic infarcts. Other computed tomography findings (not depicted) included mediastinal, right hilar, and chest wall lymphadenopathy as well as moderate ascites.

Figure 2 Views of liver biopsy demonstrating atypical mononucleate cells with very high nucleus/cytoplasmic ratios; hyperchromatic with irregularly distributed chromatin; and, irregular nuclear membranes. A: Low power view; B: High power view. Some nucleoli are infiltrating throughout the sinusoidal spaces. These are features of malignancy. The benign hepatocytes show eosinophilic granular cytoplasm and centrally placed round regular nucleus.