College of American Pathologists
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2010 — February Case of the Month

Posted February 17, 2010


CAP Foundation February 2010 Online Case of the Month

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A 58-year-old woman, who had been treated for rheumatoid arthritis with leflunomide for 10 weeks, presented with abdominal pain and jaundice. She developed fulminant hepatic failure over the course of 2 months and died while being worked up for liver transplant. The liver was smaller than normal (weight 800 grams) with a wrinkled capsule; sectioning revealed a dark red appearance with variegated yellow and green nodules.

The master list with the correct answer

  • Biliary cirrhosis, secondary
  • Budd-Chiari syndrome
  • Herpes simplex hepatitis
  • Micronodular cirrhosis
  • Sclerosing hyaline necrosis
  • Submassive hepatic necrosis

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  • Appropriate diagnosis
  • Critique
  • References

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