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An Atlas of Gross Pathology by Christopher D. M. Fletcher, Philip H. McKee

By Christopher D. M. Fletcher, Philip H. McKee

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Example text

A similar, though usually less marked, appearance may be seen in congenital hepatic fibrosis . 3 Hepatic abscess. Within the liver parenchyma is a large abscess cavity, lined by purulent material, and showing central necrosis. There is also an adjacent smaller lesion. Hepatic abscesses most often complicate suppurative cholangitis or portal pyaemia, as may be seen in diverticulitis or appendicitis. Such abscesses are commonly multiple and are usually due to infection by gut flora such as Gram-negative or anaerobic bacteria.

Multiple irregular nodules of pale secondary tumour are randomly distributed in the parenchyma of this otherwise normal liver. Metastatic involvement of the liver is extremely common and occurs most often in association with primary tumours drained by the portat venous system , particularly gastro-intestinal adenocarcinomas. The liver is also a very common site of secondary spread from carcinomas of the bronchus and breast and malignant melanoma. Metastases are very uncommon in cirrhotic tivers, probably as a consequence of alterations in hepatic blood flow.

L-,:,t~. ' >~ .. " /~~~ .. l\•. ·¥- . ';' . ,",. ~ . ';': . ~,: . d'c·... 11; •.. ~';;'. '..... I;..... ~"'. ,.. "",. ,•. ~ 'A,' . ,. ,. ,a ' ,,",' ~'. " . 12 Hepatic amyloid deposition. The liver parenchyma, originally rather waxy in appearance, has been stained with Congo Red to show extensive deposition of amyloid, particularly in the mid-zone of the lobules. Hepatic amyloidosis is most often secondary in type, being composed of serum amyloid A protein. Common' causes of secondary amyloidosis include chronic infection or chronic inflammatory disorders such as rheumatoid arthritis.

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