Multiple liver cell adenomas. COMMENT(#49 & #50): Good examples of multiple adenomas; areas of infarction/hemorrhage often found (remember microscopic characteristics).
Multiple infarction of liver--ischemic heart disease. Comment: Multifocal areas of infarction are present--easiest to see are white, sharply demarcated, with irregular borders.
Malignant melanoma metastatic to liver and spleen (no number). COMMENT (#60-64): Metastatic tumors in liver characteristically have central necrosis (umbilicated appearance through the capsule) due to outgrowth of blood/nutrient supply--other than this, variations in appearance may reflect origin of tumor i.e., the melanoma is represented by both pigmented and non-pigmented (amelanotic) metastases; choriocarcinoma typically is hemorrhagic. The cholelithiasis in #64 is unrelated to metastatic tumor)
Metastatic choriocarcinoma to liver from testis. COMMENT (#60-64): Metastatic tumors in liver characteristically have central necrosis (umbilicated appearance through the capsule) due to outgrowth of blood/nutrient supply--other than this, variations in appearance may reflect origin of tumor i.e., the melanoma is represented by both pigmented and non-pigmented (amelanotic) metastases; choriocarcinoma typically is hemorrhagic. The cholelithiasis in #64 is unrelated to metastatic tumor)
Nodular hyperplasia of liver. COMMENT: #46 and #48 have well developed scars in the presence of nodular liver tissue, these being the gross characteristics of this lesion (review microscopic characteristics).
Severe fatty metamorphosis of liver (No number). Comment on L-10 through L-12: Livers are pale, enlarged with ""rolled"" edges--one specimen (L-12) has been stained with Oil Red O to demonstrate the fat present in the tissue.
Cholangiocarcinoma and metastatic oat cell carcinoma in liver. COMMENT: Central carved-out area represents focus of cholangiocarcinoma; nodular areas=metastatic oat cell (lung) tumor (A81-512)
Finely and coarsely nodular cirrhosis of liver (mucoviscidosis sequelae). COMMENT (#40-#41): Although a finely nodular biliary cirrhosis is described, one can also see a coarsely nodular (macronodular) pattern in the livers of longstanding cystic fibrosis
Oat cell carcinoma of lung metastatic to liver. COMMENT (#60-64): Metastatic tumors in liver characteristically have central necrosis (umbilicated appearance through the capsule) due to outgrowth of blood/nutrient supply--other than this, variations in appearance may reflect origin of tumor i.e., the melanoma is represented by both pigmented and non-pigmented (amelanotic) metastases; choriocarcinoma typically is hemorrhagic. The cholelithiasis in #64 is unrelated to metastatic tumor)
Hepatoblastoma (mixed type) . COMMENT: Rare malignant tumor of liver in infancy and childhood with histologic picture consisting of cells resembling fetal liver cells, undifferentiated cells or occasionally admixed with other connective tissue elements. Prognosis usually better than hepatocellular carcinoma
Metastatic choriocarcinoma; multifaceted pigment stones in gallbladder. COMMENT (#60-64): Metastatic tumors in liver characteristically have central necrosis (umbilicated appearance through the capsule) due to outgrowth of blood/nutrient supply--other than this, variations in appearance may reflect origin of tumor i.e., the melanoma is represented by both pigmented and non-pigmented (amelanotic) metastases; choriocarcinoma typically is hemorrhagic. The cholelithiasis in #64 is unrelated to metastatic tumor)
Biliary atresia in 3 y.o. with biliary cirrhosis, esophageal varices and congested spleen. COMMENT: (#36-#37): Biliary cirrhosis--two examples--of the secondary type, i.e., secondary to atresia (or obstruction) of extrahepatic or intrahepatic bile ducts. Both are examples of micronodular cirrhosis. In the first, ectasia of intrahepatic bile ducts can be appreciated. In the second, appreciate the blood-filled submucosal esophageal varices and the enormous spleen with focal subcapsular infarcts (at top) (compare size of spleen with esophagus to appreciate the splenomegaly).
Hepatocellular carcinoma in Laennec's cirrhosis. COMMENT: Although more likely to occur in postnecrotic cirrhosis, can see this in Laennec's cirrhosis (mass in upper right = tumor)
Adenocarcinoma of bile duct. COMMENT: Tumor involves central portion of specimen--obviously in this and above five specimens, the histologic appearance is crucial to the diagnosis
