肝分葉異常の1例

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  • A CASE OF ABNORMAL LOBULATION OF THE LIVER

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An abnormally lobulated liver was detected in a 64-year-old man during surgery for liver cancer associated with cirrhosis. The abnormal lobulation presented itself as triangular pyramid-like, abnormal processes in the quadrate lobe, connected by three vessels and a small amount of hepatic parenchyma, showing solidity, color and surface condition similar to those of the cirrhotic liver. Angiography was performed on the resected liver with the abnormal lobulation, revealing that the hepatic vein had several fine vessels branching from an almost straight, relatively large vessel 1.5 mm in diameter. The portal vein, 1 mm in diameter, had a bifurcation to the right and left, and was further ramified in a pattern similar to that of segmental rami observed by portography. The hepatic vein covered the portal vein. The lesion had histological features of Nagayo's type II liver cirrhosis, with the portal vein, hepatic artery and bile duct present in the Glisson capsule. The hepatic vein showed deviation due to changes in lobular structure caused by the liver cirrhosis. Although vasculature of the dysplastic liver is found only in a report by Cullen, the vasculature in the present case was different from that presented by Cullen.

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