590 



THP: LIVER. 



is not unlikely that more than one form of lesion is grouped under this 



heading. ' 



Fatty Infiltration. In the normal human liver there is usually a cer- 

 tain amount of fat in the liver cells, and 

 . A this amount varies considerably under 



different conditions. 



The gross appearance of pathological 

 fatty livers varies a good deal, depend- 

 ing upon the amount and distribution 

 of fat and its association with other 

 changes. If the lesion is uncomplicated 

 and considerable the organ is increased 

 in size, the edges are rounded, the con- 

 sistence is firm, the color yellowish, and 

 the cut surface greasy. The lobules are 



enlarged and their outlines usually indistinct, and the blood content is di- 



FIG. 856. FATTY INFILTRATION OF LIVER 

 CELLS. 



FIG. 357. FATTY INFILTRATION OF LIVER. 



Portion of the periphery of a lobule, snowing many liver cells distended with a single large drop of fat, 

 while between these are liver cells with small fat droplets and others flattened by pressure. In this sec- 

 tion, hardened by alcohol, the fat has been dissolved, leaving clear spaces. 



minished. The liver is increased in weight. The lesion may be uniform 

 throughout the organ or it may occur in patches. In the latter case the 

 liver has a mottled appearance, irregular yellowish patches alternating 

 with the brownish -red, unaffected portions. 



Fatty infiltration is often associated with chronic congestion (nutmeg 

 liver), with cirrhosis and amyloid degeneration; the picture may then 

 present considerable complexity. Fatty livers may be stained brown or 

 greenish with bile pigment. 



1 For more important bibliography of acute yellow atrophy, see Ziegler's " Lehr- 

 buch der Pathologic," Bd. ii. 



