Medical and surgical reports . he nodules sliow umbilication,but on palpation some suggest fluctuation, as if the central portionswere much softened. The superior surface to the riglit of thefalsiformligament is almost smooth in contradistinction to the coarsely lobulatedappearance of tlie other parts of the liver, and is mottled with manysnial whitish and greenish areas, none of which measure more than .5 cm. 174 CARCINOMA OF THE LIVER. On section (Plate IV.) the liver shows large and medium-sized,rounded areas of a dark red color. About some of these there appearsto be an indefinite connecti
Medical and surgical reports . he nodules sliow umbilication,but on palpation some suggest fluctuation, as if the central portionswere much softened. The superior surface to the riglit of thefalsiformligament is almost smooth in contradistinction to the coarsely lobulatedappearance of tlie other parts of the liver, and is mottled with manysnial whitish and greenish areas, none of which measure more than .5 cm. 174 CARCINOMA OF THE LIVER. On section (Plate IV.) the liver shows large and medium-sized,rounded areas of a dark red color. About some of these there appearsto be an indefinite connective tissue capsule, but many are in directcontact with liver tissue. Between these masses the liver is yellowish-gray and appears fairly normal. There are some areas of liver tissue aslarge as 5 x 7 cm. None of the nodules seen in section show evidence ofcentral softening. The gall bladder is normal, free from adhesions, lies in a deepgroove between nodular projections of the liver, and is dark green incolor. Bile ducts PLATE IV. The portion of the inferior vena cava attached to the liver is normal. In the rectum, situated approximately 7 cm. above the internalsphincter ani muscle, there is a slightly nodular, soft, brownish-blackexcrescence which projects 1 cm. into the lumen of the rectum. Thebase of this is formed by a hard, indurated mass, whose maximumdiameter is 3 cm. There is no evidence of ulceration of mucosa in thisregion. In the areola and connective tissue between the rectum andthe sacrum is a hard, indurated mass, 10 cm. long, 3 cm. broad, and CARCINOMA OF THE LIVER. 175 nowhere more than 1 cm. thick. This follows up behind the rectum,but is nowhere attached to it except at tlie site of tlie above-describedexcrescence. This exczescence is situated cm. above the lowerlimit of this indurated mass. Section through the middle of the nodule in the rectum shows anouter irregular border of purplish-black gradually shading into grayish-white in the centre. This
Size: 1404px × 1780px
Photo credit: © The Reading Room / Alamy / Afripics
License: Licensed
Model Released: No
Keywords: ., bookcentury1800, bookdecade1860, bookpublisherbosto, bookyear1864
