Lobulated Liver

LOBULATED LIVER, dolchataya pechen, represents a change in the liver in which it appears to consist of separate lobes. Such a liver appears to have lost its normal form, is greatly deformed, and seems to be constructed from separate spherical nodules of varying sizes, connected into one mass (see separate table, fig. 1). In most cases, N. L. is the result of syphilitic liver damage; therefore, the lobulated liver is considered a characteristic change for syphilis (N. L. syphiliticum). The basis of this liver change is the focal proliferation of young connective tissue, beginning near the surface of the organ and in strands penetrating deep into it; subsequently, these strands undergo scarring and contraction, due to which deep grooves and depressions form on the surface of the liver, dividing the organ into fragments of unequal size. Regenerative proliferation of liver tissue in these fragments gives them a spherical shape. Usually, N. L. is accompanied by perhepatitis, expressed in thickening of the capsule and formation of adhesions between the liver and diaphragm. Sometimes gummas are observed in the lobulated liver (see). Very rarely, N. L. may have a non-syphilitic origin; for example, isolated cases of lobulated liver have been described on the basis of lymphogranulomatosis developing in it (N. L. lymphogranulomatosum), as well as as a result of the peculiar focal contraction of the liver in cancerous lesions (N. L. carcinomatosum).