Sumida Satoshi, Satake Nobuo, Tsuneyama Koichi
Department of Pathology and Laboratory Medicine, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, JPN.
Department of Pathology, Ehime Prefectural Central Hospital, Matsuyama, JPN.
Cureus. 2024 Jan 14;16(1):e52270. doi: 10.7759/cureus.52270. eCollection 2024 Jan.
The ectopic liver lobe is a rare anomaly and is most frequently reported as a solitary mass. Herein, we report a case of multiple (two) ectopic liver lobes detected at an autopsy. A Japanese man in his 70s died of an infectious disease associated with acquired immunodeficiency syndrome (AIDS). Autopsy revealed the incidental finding of two 1-cm masses, located anterior to the inferior vena cava. Both masses were composed of liver tissue and had internal microscopic structures resembling the porta hepatis, consisting of an outflow bile duct and blood vessels. The outflow bile duct appeared to be continuous with the common bile duct, but the connection point of the outflow vessel was unclear. The liver tissue showed fibrous thickening of the central veins and portal venopathy, including fibrosis in the portal area as well as narrowing and loss of the portal veins. There was no evidence of congestion, fibrosis, biliary stasis, or neoplasm. The incidence of hepatocellular carcinoma is higher in the ectopic liver lobe than in the proper liver, presumably due to the abnormal circulation and bile excretion pathways. The patient also presented with portal venopathy; this suggests the presence of abnormal circulatory dynamics.
异位肝叶是一种罕见的异常情况，最常被报告为单个肿块。在此，我们报告一例在尸检时发现的多发（两个）异位肝叶病例。一名70多岁的日本男性死于与获得性免疫缺陷综合征（AIDS）相关的传染病。尸检偶然发现两个1厘米大小的肿块，位于下腔静脉前方。两个肿块均由肝组织构成，具有类似肝门的内部微观结构，包括一条流出胆管和血管。流出胆管似乎与胆总管相连，但流出血管的连接点不明确。肝组织显示中央静脉纤维性增厚和门静脉病变，包括门静脉区域的纤维化以及门静脉狭窄和消失。没有充血、纤维化、胆汁淤积或肿瘤的证据。异位肝叶中肝细胞癌的发生率高于正常肝脏，推测是由于异常的循环和胆汁排泄途径所致。该患者还存在门静脉病变；这提示存在异常的循环动力学。
