Hepatosplenic T cell lymphoma (HSTL) is an extranodal lymphoma of nonactivated cytotoxic T cells that occurs within the liver, spleen and bone marrow. It is a clinical diagnostic challenge and forgotten cause for acute liver failure as it can present with liver derangement and hepatomegaly without lymphadenopathy, resembling a primary liver disease instead of a lymphoma. The histological findings of sinusoidal infiltration with atypical lymphocytes can often be subtle, overlooked or interpreted as acute hepatitis. Thus, this case presentation aims to raise awareness of this rare but aggressive condition, where accurate histological diagnosis is paramount.
Tang et al. (Sun,) studied this question.