THE LIVER. 607 



with degenerated tumor tissue often mixed with blood. The nodules are 

 sometimes hard, sometimes soft and almost diffluent. Fatty degenera- 

 tion in the tumor is frequent, and may be recognized by yellowish streaks 

 or patches on the sections. Owing to the degeneration and partial absorp- 

 tion of the central portions of the tumors, the nodules on the surface of 

 the liver frequently present a shallow depression at the centre. The 

 tumors may be sharply outlined against the adjacent liver tissue, or may 

 merge imperceptibly into it. They may be so large or numerous as to 

 occupy the greater part of the enlarged organ. The neighboring liver 

 cells may be flattened and atrophic. The tumors may press upon the 

 portal vein or its branches, or upon the gall ducts, and thus seriously 

 interfere with the functions of the organ. Sometimes, however, the 

 tumors are very large and numerous without apparent interference with 

 the function of the liver. Melanotic carcinomata sometimes occur in the 

 liver, most frequently as secondary tumors. 



In some cases, instead of forming separate, distinct nodules, the can- 

 cerous growth develops in the form of a diffuse infiltration of the organ, 

 so that the often greatly enlarged liver is irregularly mottled with w T hite 

 and reddish-brown masses, and may then somewhat resemble some forms 

 of chronic interstitial hepatitis. 



Sarcomata. Spindle -celled, melanotic, and telangiectatic sarcomata 

 may occur in the liver as secondary tumors. ' Secondary myxomata and 

 chondromata have also been described, but they are very rare. Angiosar- 

 coma may occur as a primary tumor. 2 



Cavernous lymphangiomata have been described in a few cases. Cysts, 

 usually of small size, may be formed by dilatation of the bile ducts. They 



FIG. 370.-SECO 



The section is through the entire organ, showing careinomatous tumors of various sizes and forms : 

 some are white, some are dark red from haemorrhage. The larger tumor at the left is softening at the 

 centre. 



may be multiple and contain serum, mucus, and degenerated epithelium. 

 Single cysts, apparently unconnected with the gall ducts, are occasionally 



'See Hektoen and Herrick, Trans. Assn. Am. Phys., vol. xiii., p. 385, 1898. 

 2 Arnold, Ziegler's Beitr. z. path. Anat., Bd. viii., p. 123. 



