entirely surrounded by connective-tissue, or the connective tissue
may invade the lobules. Note also size and contents of hepatic and
portal blood-vessels and bile-ducts.
The most important pathologic conditions of the liver are acute and
chronic passive congestion, thrombosis of portal veins, atrophy
(simple and brown), fatty infiltration, cloudy swelling, fatty
degeneration, acute yellow or red atrophy, amyloid, phosphorus-liver,
abscess (metastatic, tropical, purulent cholangitis), cirrhosis
(Lænnec’s or atrophic, Hanot’s or hypertrophic, fatty, biliary,
cardiac), pericarditic pseudocirrhosis, tuberculosis, syphilis
(very common: gummata, interstitial hepatitis, cirrhosis, hepar
lobatum), actinomycosis, leukæmic infiltrations, glycogen
infiltration (diabetes), pigmentations (hæmosiderosis in pernicious
anæmia, malaria, hæmolytic poisons, etc., hæmatoidin in atrophy,
bile-pigment in icterus, anthracosis, argyrosis, malaria pigment,
melanin), neoplasms (most common tumor is the cavernous angioma,
usually in old people, rarely of clinical significance; primary
carcinoma and sarcoma rare; secondary very common [melanotic sarcoma,
lymphosarcoma, metastases from carcinoma of gall-bladder and duct,
stomach, pancreas and intestine, metastases of malignant syncytioma],
adenoma and cystadenoma are rare), cysts, congenital cystic liver,
parasites (echinococcus hydatidosus, granulosis and multilocularis,
cysticercus, distomum hepaticum, pentastomum denticulatum, coccidium
oviforme).
8. =Gall-bladder.= Note _size_ (length 8-17 cm., diameter 3 cm.,
thickness of wall 1-2 mm.), _amount_ and _character of contents_
(clear and watery in hydrops, seropurulent or purulent in
inflammation, excess of mucus in catarrhal inflammation), calculi,
bile-sand, thickening and indurations of wall, œdema, character of
mucosa, carcinoma (adenocarcinoma, squamous-celled). Note size,
contents, thickness of wall and character of mucosa of ducts.
9. =Portal Vein.= Note contents, character of wall, occurrence of
stenosis, thrombosis, pylephlebitis, thrombopylephlebitis, syphilitic
changes, calcification, pressure from without.
10. =Mesentery.= Amount of fat, color, condition of vessels,
blood-content, occurrence of œdema, inflammation, abscesses,
hæmorrhages, infarction, gangrene, fat-necrosis, aneurism,
embolism, thrombosis, cysts, parasites (bilharzia hæmatobia),
tumor-infiltrations and primary tumors (lipoma).
11. =Mesenteric Glands.= Size, appearance on section (rose-red
in acute inflammation, grayish-white in chronic), occurrence of
tubercles, secondary tumors, calcification, abscesses, pigmentation,
typhoid necrosis, primary lymphosarcoma, leukæmic hyperplasia,
Hodgkin’s, etc.
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