Pathology: cirrhosis

What can be learned from a gross specimen of cirrhosis such as this?  Several things, of course.  You might begin with acknowledging that the liver is rather large.  Even though you learned that cirrhosis is associated with a small, shrunken liver? Well, that depends on the etiology of cirrhosis.  In this patient with Wilson disease, as in other depositional or infiltrative diseases, the liver can be large. 

Also notice the left lobe hypertrophy.  This is a classic finding of cirrhosis, and should be identified in the patient’s midline (below the xyphoid process) on physical exam.  If you trace the contour of this liver, you will notice its nodularity.  Nodular (or lobular) is the key word to look for on ultrasound, CT and MRI reports that will tip you off to the diagnosis of cirrhosis.

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