Laparoscopic Findings of the Liver of Adult T cell Leukemia with Hepatic Injury— A Case Report

: A 54 year- old man was admitted to our hospital because of general fatigue and marked hepato -splenomegaly. Laboratory findings revealed marked leukocytosis including atypical lymphocytosis and abnormalities in the hepatic function tests. A diagnosis of acute stage of adult T-cell leukemia (ATL) was made from his positive serum anti-ATL (HTLV-1). Since the complication of alcoholic liver disease could not be ruled out because of his heavy consumption of alcohol, hepato - splenomegaly and abnormal liver function tests, a laparoscopic examination was performed. The laparoscopic findings of the liver revealed it was yellow / brown in color, and showed swelling of both lobes, granular unevenness and diffuse white markings on the surface. Histological findings of the liver biopsy specimen revealed an enlargement of the portal areas with diffuse infiltration of ATL cells but no evidence of alcoholic liver diseases. It is suggested that the white markings on the liver surface, which showed slight elevation unlike those seen in chronic hepatitis, might reflect an infiltration of ATL cells.