Adult T-cell leukemia presenting with acute liver failure

Malignant infiltration of the liver is a rare cause of acute liver failure accounting for less than 1% of cases. We describe a case of adult T-cell leukemia (ATL) that presented with a prodromal illness that progressed to jaundice, hepatic encephalopathy, multisystem failure and death within 8 weeks. Liver histology revealed massive infiltration with atypical lymphocytes typical of ATL and liver necrosis.