• Epigenetics
• HDAC
• Memory

• Animals
• Histone Deacetylases/metabolism
• Histone Deacetylases/genetics
• Rats
• Disease Models, Animal
• Male
• Hepatic Encephalopathy/pathology
• Hepatic Encephalopathy/genetics
• Hepatic Encephalopathy/physiopathology
• Hepatic Encephalopathy/metabolism
• Ligation
• Bile Ducts/surgery
• Up-Regulation
• Behavior, Animal
• Rats, Sprague-Dawley
• Maze Learning
• Histone Deacetylase 6/metabolism
• Histone Deacetylase 6/genetics
• Hippocampus/metabolism
• Neurons/metabolism
• Neurons/pathology

• Acute liver failure
• fulminant hepatitis
• hepatic malignant infiltration
• lactic acidosis
• non-Hodgkin lymphoma

• ALK fusion
• alectinib
• hemolytic anemia
• liver failure
• lorlatinib

• Humans
• Aminopyridines/therapeutic use
• Anaplastic Lymphoma Kinase/genetics
• Anaplastic Lymphoma Kinase/antagonists & inhibitors
• Anemia, Hemolytic/chemically induced
• Carbazoles/adverse effects
• Carcinoma, Non-Small-Cell Lung/complications
• Carcinoma, Non-Small-Cell Lung/drug therapy
• Carcinoma, Non-Small-Cell Lung/genetics
• Lactams/therapeutic use
• Lactams, Macrocyclic/therapeutic use
• Lactams, Macrocyclic/pharmacology
• Liver Failure/etiology
• Lung Neoplasms/drug therapy
• Lung Neoplasms/pathology
• Piperidines/adverse effects
• Pyrazoles/therapeutic use
• Tyrosine Kinase Inhibitors/adverse effects

• HAIC
• hepatic artery infusion therapy
• histomorphological pattern
• prognosis
• survival

• Humans
• Uveal Neoplasms/pathology
• Uveal Neoplasms/drug therapy
• Uveal Neoplasms/mortality
• Female
• Male
• Melanoma/drug therapy
• Melanoma/pathology
• Melanoma/mortality
• Liver Neoplasms/secondary
• Liver Neoplasms/drug therapy
• Middle Aged
• Infusions, Intra-Arterial
• Retrospective Studies
• Hepatic Artery
• Aged
• Antineoplastic Agents/therapeutic use
• Survival Rate
• Adult
• Treatment Outcome
• Prognosis

• acute hypoxic respiratory failure
• acute liver failure
• brca2
• colorectal cancer
• early-onset crc
• metastasis
• obstructive features

• Acute liver failure
• CLIF-SOFA
• Hemophagocytic lymphohistiocytosis

• Humans
• Lymphohistiocytosis, Hemophagocytic/mortality
• Lymphohistiocytosis, Hemophagocytic/diagnosis
• Lymphohistiocytosis, Hemophagocytic/complications
• Lymphohistiocytosis, Hemophagocytic/etiology
• Retrospective Studies
• Male
• Female
• Middle Aged
• Adult
• Prognosis
• Aged
• Liver Failure, Acute/mortality
• Liver Failure, Acute/etiology
• Liver Failure, Acute/diagnosis
• Liver Failure, Acute/complications
• Liver/pathology
• Severity of Illness Index
• Liver Diseases/mortality
• Liver Diseases/etiology
• Liver Diseases/complications
• Liver Diseases/diagnosis

• autopsy
• liver failure, acute

• Male
• Humans
• Aged
• Acidosis, Lactic/diagnosis
• Acidosis, Lactic/etiology
• Liver Failure, Acute/etiology
• Liver Failure, Acute/complications
• Lymphoma, Large B-Cell, Diffuse/complications
• Lymphoma, Large B-Cell, Diffuse/diagnosis
• Abdominal Pain

• Case report
• Hepatitis
• Hodgkin lymphoma
• Nodular lymphocyte-predominant Hodgkin lymphoma
• Paraneoplastic hepatitis

• Acute liver failure
• Liver transplantation
• Malignancy
• Therapeutic

• Case report
• Liver failure
• Malignant infiltration
• Polymyositis
• cancer of unknown primary

• 82172034 National Natural Science Foundation of China

• Acute liver failure
• Neuroendocrine tumor/neoplasm (NET/NEN)
• Primary hepatic neuroendocrine carcinoma (PHNEC)
• Pulmonary hemorrhage

Littoral cell angioma (LCA) is a rare benign vascular tumor of the spleen. Given its rarity, standard diagnostic and therapeutic recommendations have yet to be developed for reported cases. Splenectomy is the only method of obtaining a pathological diagnosis and providing treatment to obtain a favorable prognosis.

A 33-year-old female presented with abdominal pain for one month. Computed tomography and ultrasound revealed splenomegaly with multiple lesions and two accessory spleens. The patient underwent laparoscopic total splenectomy and accessory splenectomy, and splenic LCA was confirmed by pathology. Four months after surgery, the patient presented with acute liver failure, was readmitted, rapidly progressed to multiple organ dysfunction syndrome and died.

Preoperative diagnosis of LCA is challenging. We systematically reviewed online databases to identify the relevant literature and found a close relationship between malignancy and immunodysregulation. When a patient suffers from both splenic tumors and malignancy or immune-related disease, LCA is possible. Due to potential malignancy, total splenectomy (including accessory spleen) and regular follow-up after surgery are recommended. If LCA is diagnosed after surgery, a comprehensive postoperative examination is needed.

• Littoral cell angioma
• Imaging features
• Malignancy
• Immunodysregulation
• Treatment
• Case report

• acute liver failure (alf)
• alt (alanine aminotransferase)
• ast (aspartate aminotransferase)
• ct abdomen
• liver metastasis
• miliary metastasis
• non- small cell carcinoma

• Case report
• Chemotherapy
• Hepatitis
• Leukemia
• Ultrasound

• acute hepatitis
• acute liver failure
• adult t-cell lymphoma/leukemia
• hawaii
• human t-cell lymphocytic virus-1
• hyperbilirubinemia
• marshallese
• micronesia

• Aged
• Diagnosis, Differential
• HTLV-I Infections/complications
• HTLV-I Infections/diagnosis
• Human T-lymphotropic virus 1
• Humans
• Liver Failure, Acute/complications
• Liver Failure, Acute/diagnosis
• Lymphoma, T-Cell/complications
• Lymphoma, T-Cell/diagnosis
• Male
• Micronesia
• Palliative Care

• chemotherapy
• liver transplantation
• malignancy
• neoplasm
• outcome

Malignant liver infiltration is an uncommon cause of acute liver failure (ALF) and has rarely been reported.

We present a patient with progressive jaundice and dissociation of bilirubin and aminotransferases, who had no history of relevant liver diseases or tumor except the use of Chinese traditional drugs for a cold. An abdominal computed tomography (CT) scan showed ascites without hepatic focal lesions. Laboratory studies revealed no evidence of hepatitis or underlying autoimmune disorders. Following 8 days of conservative management ALF rapidly worsened. Contrast-enhanced CT revealed diffuse regenerative nodules in the liver. The patient underwent liver biopsy, which demonstrated that the liver was infiltrated by pulmonary neuroendocrine tumor classified as small cell lung cancer. The patient died 13 days after diagnosis.

This case represents a rare cause of ALF induced by pulmonary neuroendocrine tumor of small cell type and illustrates the importance of prompt biopsy in an unknown cause of ALF.

• acute liver failure
• biopsy
• case report
• pulmonary neuroendocrine tumor
• small cell lung cancer

There is limited real-world safety information on palbociclib for treatment of advanced stage HR+/HER2- breast cancer.

We conducted a cohort study of breast cancer patients initiating palbociclib and fulvestrant from February 2015 to September 2017 using the HealthCore Integrated Research Database (HIRD), a longitudinal claims database of commercial health plan members in the United States.

The historical comparator cohort comprised patients initiating fulvestrant monotherapy from January 2011 to January 2015. Propensity score matching and Cox regression were used to estimate hazard ratios for various safety events. For acute liver injury (ALI), additional analyses and medical record validation were conducted.

There were 2445 patients who initiated palbociclib including 566 new users of palbociclib-fulvestrant, and 2316 historical new users of fulvestrant monotherapy. Compared to these historical new users of fulvestrant monotherapy, new users of palbociclib-fulvestrant had a greater than 2-fold elevated risk for neutropenia, leukopenia, thrombocytopenia, stomatitis and mucositis, and ALI. Incidence of anemia and QT prolongation were more weakly associated, and incidences of serious infections and pulmonary embolism were similar between groups after propensity score matching. After adjustment for additional ALI risk factors, the elevated risk of ALI in new users of palbociclib-fulvestrant persisted (e.g. primary ALI algorithm hazard ratio (HR) = 3.0, 95% confidence interval (CI) = 1.1–8.4).

This real-world study found increased risks of several adverse events identified in clinical trials, including neutropenia, leukopenia, and thrombocytopenia, but no increased risk of serious infections or pulmonary embolism when comparing new users of palbociclib-fulvestrant to fulvestrant monotherapy. We observed an increased risk of ALI, extending clinical trial findings of significant imbalances in grade 3/4 elevations of alanine aminotransferase (ALT).

The online version contains supplementary material available at 10.1186/s12885-021-07790-z.

• Acute liver injury
• Epidemiology
• Palbociclib
• Real-world
• Safety

• cancer - see oncology
• pancreatic cancer

Liver involvement by non-Hodgkin’s lymphoma is common in late stage disease but rarely results in severe hepatic dysfunction. Here, we discuss a case of acute liver failure (ALF) with severe lactic acidosis in a 75-year-old female with diffuse large B-cell lymphoma (DLBCL). The patient was admitted with nausea, fevers, and mild acidosis. Although radiographic imaging did not demonstrate any liver abnormality, the patient soon developed signs of ALF along with severe lactic acidosis. Despite initiation of chemotherapy, the patient deteriorated quickly and was ultimately put on comfort measures. This case highlights an uncommon manifestation of DLBCL and suggests that an accelerated timeline for beginning chemotherapy may be warranted in patients with high clinical suspicion of secondary hepatic lymphoma.

• acute liver failure
• dlbcl
• lactic acidosis
• secondary hepatic lymphoma

A 70-year-old female with a history of lobular carcinoma of the breast, status post-mastectomy followed by adjuvant radio-chemotherapy in remission for 4 years was admitted with the features of acute liver failure (ALF). Iron studies revealed a hemochromatosis picture and the CT and MRI scans of the abdomen suggested cirrhosis. An extensive workup failed to identify an etiology. A trans-jugular liver biopsy was obtained and revealed poorly differentiated carcinoma consistent with the metastasis of breast primary. The patient’s condition deteriorated and died within a week following the onset of acute hepatic failure. DNA testing revealed that the patient was heterozygous for H63D mutation. In cases of ALF with the suspicion of malignancy, liver biopsy should be obtained to evaluate an infiltrative hepatic disease.

• acute liver failure
• diagnostic dilemma
• infiltrative liver metastasis

• acute hepatitis
• cervical cancer
• metastatic cervical cancer

Acute liver failure (ALF) associated with malignant infiltration of the liver is rare and its pathological and radiologic features remain poorly described. An 87-year-old man was admitted to our hospital for anorexia for several days, high-grade fever from the previous day, and liver dysfunction but suddenly died on day 3 of hospitalization due to ventricular fibrillation. The patient was diagnosed at autopsy with malignant diffuse large B-cell lymphoma. To the best of our knowledge, this report represents a valuable addition to the ALF literature describing a case of ALF associated with diffuse large B-cell lymphoma diagnosed at autopsy.

• Acute liver failure
• Diffuse large B-cell lymphoma
• Malignant lymphoma
• Multiple hypodense splenic lesions

• Aged, 80 and over
• Autopsy
• Humans
• Liver Failure, Acute/etiology
• Lymphoma, Large B-Cell, Diffuse/complications
• Male

• Acute hepatitis
• Acute liver failure
• Liver biopsy
• Mitochondrial disorders
• Pathology

• Acute Disease
• Biopsy
• Hepatitis/pathology
• Humans
• Liver Failure, Acute/pathology
• Mitochondrial Diseases/pathology

• acute liver failure
• acute myeloid leukaemia
• obstructive jaundice

Acute liver failure is characterized by encephalopathy and disruption of hepatic function, often requiring liver transplantation to prevent fatal consequences. We present a 33-year-old man with recurrent lymphoma presenting with acute liver failure, which was initially thought to be from drug-induced liver injury associated with his chemotherapy medication, asparaginase. However, liver biopsy revealed malignant infiltration by lymphoma. The subtype of lymphoma was natural killer–like T-cell lymphoma, which is an uncommon variant, and has rarely been associated with hepatic infiltration. His condition rapidly worsened with development of multiorgan failure leading to death.

• Acute Liver Failure
• Hepatomegaly
• Liver Metastasis
• Small Cell Lung Carcinoma

Breast cancer is common among females worldwide and is most commonly reported in women aged 30–40 years and less commonly in those aged <30 years. Presentation with liver metastasis is rare in breast cancer at all ages. Lactic acidosis in association with metastatic breast cancer is also rare. Here, the authors report a case of a 26-year-old female who presented with cholestatic jaundice, coagulopathy and ascites. Radiological examination showed evidence of infiltrating liver lesion. Computed tomography-guided liver biopsy confirmed the diagnosis of adenocarcinoma of breast origin based on the strong estrogen receptor positivity. Chemotherapy could not be initiated because of the patient's critical condition. Unfortunately, the condition deteriorated rapidly, and the patient died secondary to liver failure manifested with disseminated intravascular coagulation and lactic acidosis. This is a rare case of breast cancer in terms of age group (<30 years), site of metastasis at presentation and complication of metastatic breast cancer (type B lactic acidosis), and thus highlights the distinct features of such breast cancers.

• Breast cancer
• lactic acidosis
• liver metastasis
• young female

Acute liver failure (ALF) secondary to malignant infiltration of the liver from urothelial carcinoma is a very rare clinical condition and is often diagnosed only after death. Upper tract urothelial carcinoma (UTUC) is a rare, from 5% to 10% of all urothelial tumours, but possible cause of ALF when there is extensive liver metastatic involvement. We report the case of a patient who died in the intensive care unit (ICU) of our hospital from multiple organ failure (MOF) secondary to ALF, as a result of infiltration of the liver from UTUC diagnosed after surgery.

PRESENTATION OF THE CASE: A 69-year-old Caucasian man was referred to our hospital for hematuria, melena, right upper quadrant (RUQ) pain and jaundice developed over the previous two weeks. After multidisciplinary discussion, he underwent emergency exploratory laparotomy to perform cholecystectomy because of suspected acute cholecystitis considered as a septic focus within the left kidney. He developed MOF and died on the 6th postoperative day.

From the diagnosis of the renal mass and the death of the patient, a few days have passed, and the diagnosis of UTUC has been put only at histological examination.The most common sites of metastases from UTUC are lymph nodes, lungs, liver, bones and peritoneum. Moreover, liver metastases have been identified to have an independent negative impact on overall survival in a patient affected by UTUC.

The authors suggest that this condition should be taken into account when dealing with patients with evidence of a renal mass and simultaneous ALF.

•

Unusual clinical presentation of acute liver failure from upper urothelial carcinoma (UTUC).

• Acute liver failure
• Emergency surgery
• Upper tract urothelial carcinoma (UTUC)

• Hepatitis
• Hodgkin
• Liver involvement
• Lymphoma
• Lymphoproliferative disorders
• Vanishing bile duct syndrome

Acute liver failure (ALF) is a relatively rare presentation of non-Hodgkin lymphoma, often found only during postmortem examination in patients. We treated a 33-year-old woman with prominent jaundice who was diagnosed with diffuse large B-cell lymphoma presenting as ALF. We could not perform liver biopsy during the critical phase because of coagulopathy, but gastric biopsy showed the infiltration of lymphoma cells. The patient was successfully treated with rituximab and chemotherapy and she survived. Malignant lymphoma should be considered in the differential diagnosis of patients who show liver dysfunction, and biopsy should be performed.

• Acute Liver Failure (ALF)
• Diffuse Large B Cell Lymphoma (DLBCL)
• hepatic lymphoma

Metastatic carcinomatosis cirrhosis is a pattern of metastasis in which malignancy infiltrates the liver and provokes hepatic fibrosis. It is an especially rare complication of several malignancies, including breast cancer. We report a case of a 61-year-old woman with lobular carcinoma of the breast who presented with confusion and rising serum tumor markers without evidence of disease recurrence on imaging. She subsequently developed clinical evidence of hepatic dysfunction and a liver biopsy revealed diffuse infiltration of the liver by breast carcinoma with surrounding fibrous tissue deposition, consistent with metastatic carcinomatosis cirrhosis. This case highlights a rare and clinically significant pattern of metastasis and is the first to describe lobular carcinoma of the breast causing metastatic carcinomatosis cirrhosis.

• breast cancer
• hepatic cirrhosis
• hepatic tumor
• liver cirrhosis
• liver failure
• liver metastases
• metastatic disease

A 75-year-old woman with a 50-pack-year history of tobacco abuse presented with abdominal pain, encephalopathy and elevated liver enzymes. Serologic evaluation for viral hepatitis, drug levels and chronic liver disease panel was negative. Computed tomography (CT) scan of the abdomen showed hepatomegaly and a large area of decreased attenuation in the lateral segment of the left lobe of the liver which was also demonstrated on the magnetic resonance cholangiopancreatography. CT of the chest was significant for a 1.4 cm left peripheral lingular nodule. Hepatic mass biopsy revealed small cell carcinoma (SCC), favoring lung primary. She had persistent liver failure with encephalopathy, coagulopathy and elevated liver enzymes during her hospital stay. Acute liver failure (ALF) is characterized by liver damage, encephalopathy and coagulopathy in patients without any prior history of liver disease. Although malignant infiltration has been described as a cause of ALF, SCC of the lung is an uncommon etiology.

• acute liver failure
• small cell cancer
• small cell carcinoma

• Bone marrow microenvironment
• Drug delivery
• Hematological malignancies
• Liposomes
• Micelles
• Nanomedicines

• Biomarkers, Tumor
• Carcinoma, Neuroendocrine/chemistry
• Carcinoma, Neuroendocrine/diagnosis
• Carcinoma, Neuroendocrine/secondary
• Delayed Diagnosis
• Fatal Outcome
• Humans
• Liver Failure, Acute/etiology
• Liver Failure, Acute/therapy
• Liver Neoplasms/chemistry
• Liver Neoplasms/diagnosis
• Liver Neoplasms/secondary
• Male
• Middle Aged
• Multiple Organ Failure/etiology
• Multiple Organ Failure/therapy
• Neoplasms, Unknown Primary/complications

• Adenocarcinoma/complications
• Adenocarcinoma/secondary
• Adult
• Aged, 80 and over
• Biopsy
• Carcinoma, Small Cell/complications
• Carcinoma, Small Cell/secondary
• Female
• Hepatic Encephalopathy/etiology
• Humans
• Jaundice/etiology
• Liver Failure, Acute/complications
• Liver Failure, Acute/etiology
• Liver Function Tests
• Liver Neoplasms/complications
• Liver Neoplasms/secondary
• Lung Neoplasms/pathology
• Male
• Medical Records
• Middle Aged
• Retrospective Studies

Acute liver failure (ALF) induced by diffuse metastatic disease has rarely been reported.

We present a 51-years-old woman with relevant clinical history for breast cancer. The patient was admitted in the emergency department with jaundice, dark urine and pale stools. She was on the 10th day of hormonotherapy for recurrence of breast cancer, diagnosed 7 years previously. Usual causes of acute liver failure were excluded, all drugs were stopped and the imaging studies performed were positive only for steatosis. Nonetheless, ALF progressed and the patient died 4 days later. Autopsy demonstrated a massive intrasinusoidal infiltration of the liver by breast cancer cells.

We highlight a rare cause of ALF. Although uncommon, physicians should be alert for this situation as the diagnosis can be challenging and the imaging studies can remain normal.

• Acute liver failure
• Diffuse malignant infiltration

• Hepatic neoplasms
• Liver
• Non-Hodgkin lymphoma
• Primary hepatic lymphoma

Hemophagocytic lymphohistiocytosis (HLH) and newly diagnosed malignant infiltration of liver are rare presentations of acute liver failure associated with poor prognosis. We report a case of a patient with acute liver failure caused by malignant infiltration by diffuse large B-cell lymphoma and secondary HLH.